Pediatric versus Adult Corneal Collagen Crosslinking: Long-term Visual, Refractive, Tomographic and Aberrometric Outcomes


Ucakhan Ö. Ö., Buyuktepe T. C., YAVUZ Z., Asbell P. A.

CURRENT EYE RESEARCH, vol.46, no.1, pp.14-22, 2021 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 46 Issue: 1
  • Publication Date: 2021
  • Doi Number: 10.1080/02713683.2020.1782940
  • Journal Name: CURRENT EYE RESEARCH
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, EMBASE, MEDLINE
  • Page Numbers: pp.14-22
  • Keywords: Collagen crosslinking, keratoconus, corneal ectasia, ultraviolet a, riboflavin, pediatric keratoconus, PROGRESSIVE KERATOCONUS, CONTROLLED-TRIAL, RIBOFLAVIN, ULTRAVIOLET, CHILDREN, ACUITY, LIGHT
  • Ankara University Affiliated: Yes

Abstract

Purpose To comparatively evaluate the long-term visual, refractive, topographic and aberrometric outcomes of conventional corneal collagen crosslinking (CXL) in the management of pediatric versus adult progressive keratoconus patients. Materials and Methods Retrospective, cross-sectional review of consecutive progressive keratoconus cases of corneal standard CXL using a standardized protocol for treatment and examinations was performed. Best spectacle-corrected distance visual acuity (CDVA), manifest refraction, slit lamp biomicroscopy, corneal tomography, corneal aberrometry and endothelial cell counts were evaluated at baseline and yearly at all postoperative follow-up examinations after month-12. The outcomes were analyzed by dividing the patients into 2 age groups; pediatric (<= 18 years) versus adult (>18 years). Results Eighty-eight eyes (54 patients) in the pediatric and 104 eyes (68 patients) in the adult age groups completed 3 years follow-up. Compared to baseline, the mean CDVA, manifest refraction, keratometric readings, tomographic and aberrometric parameters improved statistically significantly in both groups at postoperative year-3 and year-4, without any statistically significant between-group differences. No change in the mean endothelial cell density (p> .05), or no sight threating complication was encountered in any patient eye in either group. In a subset of patients who were followed for 4 years (71 eyes in the pediatric and 70 eyes in the adult age groups), the outcome analyses were again similar between-groups. Conclusion Conventional corneal CXL effectively halts the progression of keratoconus in both pediatric and adult age groups in long-term follow-up with similar visual, refractive, tomographic and aberrometric efficacy in both groups.