Keratoconus in Children. Мodern Treatment Options
https://doi.org/10.18008/1816-5095-2021-4-840-844
Abstract
Objective: to evaluate the results of corneal collagen crosslinking in children with keratoconus.
Patients and methods. Since 2017, 125 children aged 4 to 17 years have been under observation, who have applied to the Eye Microsurgery named after Academician S.N. Fedorov with complaints of reduced visual acuity and, in some cases, the inability to select optical correction. All patients were examined, including using high-tech methods (Sheimpflug camera, OCT). Based on the anamnesis and the data obtained, the diagnosis of keratoconus stage I–III was made. Corneal collagen crosslinking was performed in 30 patients with stage II–III.
Results. The study included 30 eyes of 30 patients (21 (68 %) boys, 9 (32 %) girls) with a median age — 16 (15; 17) years (12 to 17 years), who underwent accelerated “epi-off” crosslinking. No intra-and postoperative complications were observed. 12 months after CXL, there was a slowdown in the progression of keratoconus in children (minimum corneal thickness before surgery 460.00 (445.00; 477.00), after surgery 457.00 (441.00; 477.00), p = 0.112; K1 before surgery 44.60 (43.20; 46.90), after surgery 44.60 (42.90; 46.50), p = 0.481; K2 before surgery 48.30 (47.30; 51.25), after surgery 48.20 (47.21; 49.20), p = 0.779; elevation of the posterior surface before surgery 25.00 (18.00; 42.00), after surgery 26.00 (21.00; 42.00), p = 0.074, and increased visual acuity (NCOZ from 0.30 (0.05; 0.40) to 0.30 (0.20; 0.40) (p = 0.039) and MCOZ from 0.60 (0.40; 0.80) to 0.60 (0.50; 1.00) (p = 0.010)).
Conclusion. 1. Keratoconus is also found in the child population. 2. Timely cross-linking of corneal collagen can slow the progression of keratoconus in children
About the Authors
E. Yu. Markova
S. Fyodorov Eye Microsurgery Federal State Institution
Russian Federation
Russian Federation
Markova Elena Yu., MD, head of the microsurgery and functional rehabilitation of children’s eye depart‑
ment
Beskudnikovsky blvd, 59A, Moscow, 127486
G. V. Avakyants
S. Fyodorov Eye Microsurgery Federal State Institution
Russian Federation
Russian Federation
Avakyants Goar V., postgraduate
Beskudnikovsky blvd, 59A, Moscow, 127486
E. V. Kechin
S. Fyodorov Eye Microsurgery Federal State Institution
Russian Federation
Russian Federation
Kechin Evgeny V., PhD, researcher of the organizational and methodological department
Beskudnikovsky blvd, 59A, Moscow, 127486
References
1. Markova E.Yu., Kostenyov S.V., Grigorieva A.G., Perfilieva E.A. Current trends in the treatment of keratoconus in children. Оphthalmology in Russia = Oftal’mologiya. 2017;14(3):188–194 (In Russ.). DOI: 10.18008/1816-5095-2017-3-188-194
2. Rabinowitz Y.S. Keratoconus. SurvOphthalmol. 1998;42;297–319. DOI: 10.1016/ s0039-6257(97)00119-7
3. Bykhovskaya Y., Li X., Epifantseva I., Haritunians T. Variation in the lysyl oxidase (LOX) gene is associated with keratoconus in family-based and case-control stud ies. Invest Ophthalmol VisSci. 2012;53(7);4152–4157. DOI: 10.1167/iovs.11-9268
4. Cheung I.M., McGee C.N., Sherwin T. A new perspective on the pathobiology of keratoconus: inter play of stromal wound healing and reactives pecies-associated processes. Clin Exp Ophthalmol. 2013;96;188–196. DOI: 10.1111/cxo.12025
5. Kankariya V.P., Kymionis G.D., Diaknois V.F. Management of pediatric keratoco nus — evolving role of corneal collagen cross-linking: an update. Ind J Ophthalmol. 2013;61(8);435–440. DOI: 10.4103/0301-4738.116070
6. Kamiya K., Shimizu K., Ohmoto F. Effect of aging on corneal biochemical param eters using the ocular response analyzer. J Refract Surg. 2009;25:888–893. DOI: 10.3928/1081597X-20090917-10
7. Rehany U., Rumelt S. Corneal hydrops associated with vernal conjunctivitis as a presenting sign of keratoconus in children. Ophthalmology. 1995;102(12):2046– 2049. DOI: 10.1016/s0161-6420(95)30755-5
8. Reeves S.W., Stinnett S., Adelman R.A. Risk factors for progression to penetrating keratoplasty in patients with keratoconus. Am J Ophthalmol. 2005;140(4):607–611. DOI: 10.1016/j.ajo.2005.05.029
9. Caputo R., Versaci F., Pucci N., de Libero C. Very low prevalence of keratoconus in a large series of vernal keratoconjunctivitis patients. Am J Ophthalmol. 2016;172:64– 71. DOI: 10.1016/j.ajo.2016.09.009
10. Rabinowitz Y.S., Garbus J., McDonnell P.J. Computer-assisted corneal topography in family members of patients with keratoconus. Arch Ophthalmol. 1990:108(3):365– 371. DOI: 10.1001/archopht.1990.01070050063032
11. Tuf S.J., Moodaley L.C., Gregory W.M. Prognostic factors for the progression of keratoconus. Ophthalmology. 1994;101:439–447.
12. Gomes J.A., Tan D., Rapuano C.J., Belin M.W., Ambrósio R. Jr, Guell J.L., Male caze F., Nishida K., Sangwan V.S.; Group of Panelists for the Global Delphi Panel of Keratoconus and Ectatic Diseases. Global consensus on keratoconus and ectatic diseases. Cornea. 2015 Apr;34(4):359–369. DOI: 10.1097/ICO.0000000000000408
13. Arora R., Gupta D., Goyal J.L., Jain P. Results of corneal collagen cross-linking in pediatric patients. J Refract Surg. 2012;28:759–762. DOI: 10.3928/1081597X20121011-02
14. Bakshi E., Barkana Y., Goldich Y., Avni I., Zadok D. Corneal Cross-Linking for Pro gressive Keratoconus in Children: Our Experience. Int J KeratocoEctatic Corneal Dis. 2012;1:53–56.
15. Buzzonetti L., Petrocelli G. Transepithelial corneal cross-linking in pediatric pa tients: Early results. J Refract Surg. 2012;28:763–767. DOI: 10.3928/1081597X20121011-03
16. Caporossi A., Mazzotta C., Baiocchi S., Caporossi T., Denaro R., Balestrazzi A. Ri boflavin-UVA-induced corneal collagen cross-linking in pediatric patients. Cornea. 2012;31:227–231.
17. Chatzis N., Hafezi F. Progression of keratoconus and efficacy of pediatric [cor rected] corneal collagen cross-linking in children and adolescents. J Refract Surg. 2012;28:753–758. DOI: 10.3928/1081597X-20121011-01
18. Magli A., Forte R., Tortori A., Capasso L., Marsico G., Piozzi E. Epitheli um-off corneal collagen cross-linking versus transepithelial cross-linking for pediatric keratoconus. Cornea. 2013;32:597–601. DOI: 10.1097/ICO. 0b013e31826cf32d
19. Soeters N., Van der Lelij A., van der Valk R., Tahzib N.G. Corneal crosslinking for progressive keratoconus in four children. J Pediatr Ophthalmol Strabismus. 2011;21:48.
20. Vinciguerra P., Albé E., Frueh B.E., Trazza S., Epstein D. Two-year corneal cross-linking results in patients younger than 18 years with documented pro gressive keratoconus. Am J Ophthalmol. 2012;154:520–526. DOI: 10.1016/j. ajo.2012.03.020
21. Zotta P.G., Moschou K.A., Diakonis V.F., Kymionis G.D., Almaliotis D.D., Karamitsos A.P. Corneal collagen cross-linking for progressive keratoconus in pediatric patients: A feasi bility study. J Refract Surg. 2012;28:793–799. DOI: 10.3928/1081597X-20121011-0
Review
For citations:
Markova E.Yu., Avakyants G.V., Kechin E.V. Keratoconus in Children. Мodern Treatment Options. Ophthalmology in Russia. 2021;18(4):840-844. (In Russ.) https://doi.org/10.18008/1816-5095-2021-4-840-844
Views:
828
Email this article 