OUTCOMES OF CORNEAL COLLAGEN CROSS LINKING IN PEDIATRIC KERATOCONUS IN UPPER EGYPT

Abstract

Purpose: To assess the short term visual, refractive, and tomographic outcomes of corneal collagencross-linking (CXL) in pediatric patients with keratoconus. Patients and Methods: A prospectiveinterventional non-comparative case series study that was conducted in The Future Center forrefractive surgery, Sohag, in the period from May 2017 to October 2018, All the eyes were treatedwith accelerated trans-epithelial corneal cross-linking under topical or general anesthesia and thefollowing data were collected at baseline,3 months, 6 months, and 12 months postoperatively for allpatients: uncorrected- and best-corrected visual acuity, sphere, spherical equivalent, cylinder, andtomographic findings. Results: A total of 50 eyes of 25 patients, 16 males (64%) and 9 females(36%) were included. Mean age at surgery was 15.76±1.67 years (range, 13-18). Mean uncorrectedvisual acuity was 0.83±0.30 logMAR at baseline and 0.74±0.33 logMAR at 12 months (P=0.009).Mean preoperative best-corrected visual acuity was 0.52±0.28 logMAR, which improved to 0.31±0.27logMAR at 12 months (P 0.05). There wasnon-significant reduction in the mean thinnest corneal area from baseline (453.36±40.50 mm) to12 months (447.84±46.51 mm), (P=0.06). There were no significant postoperative complications.One case show progression at the 12th month as the followings were noticed; The cylinder increasedfrom -7.00 to -10.50, The flattest K increased from 55 D to 59 D, The steepest K increased from 58 Dto 61 D, the corneal thickness at thinnest location decreased from 400 µm to 381 µm. Conclusion:In this study CXL effectively stabilized keratometry values at 12 month, while improving uncorrectedvisual acuity, best corrected visual acuity, and refractive indices.