Pediatric Keratoconus: Topographic, Biomechanical and Aberrometric Characteristics

Abstract

This study sought to evaluate the demographic profile, clinical features, topographic features, and biomechanical and aberrometric characteristics in pediatric keratoconus (KC). Cross-sectional study. Pediatric KC cases <18 years of age were evaluated at a tertiary hospital. Main outcome measurements were demographic profile, clinical features, visual acuity, corneal topography, aberrometry, and biomechanical and confocal microscopy findings. A total of 116 eyes of 62 consecutive patients were recruited with a mean ± age of 14.7 ± 2.77 years (range: 8-18 years); 46 of 62 (88%) were males; 57 of 62 cases (92%) had bilateral disease; 53 of 116 eyes (46%) had progressive KC; and 9 of 116 eyes (8%) had acute hydrops. Systemic associations were found in 6 of 62 patients (9.7%) and ocular associations in 77 of 116 eyes (66.3%); 68 of 116 eyes (58.6%) had associated vernal keratoconjunctivitis (VKC). Among eyes with VKC, 29 of 68 eyes (46%) were in stage IV KC, versus 25% of eyes with no VKC (P= .004). The mean ± SD refractive spherical equivalent was-4.72 ± 3.32 diopters (D), and refractive astigmatism was 3.69 ± 3.09 D. The mean values of maximum keratometry, thinnest pachymetry, and corneal higher-order aberrations were 60.89 ± 10.9 D, 396.05 ± 95.03μm, and 1.18 ± 1.2μm, respectively. Values of corneal hysteresis and corneal resistance factor correlated with the stage of KC (r=-0.26; P= .007). Pediatric KC was commonly associated with VKC in this cohort. Eyes with VKC had more severe KC than those without VKC. Nearly half of the patients presented with progressive disease. Corneal biomechanical changes correlated well with stage of KC in this pediatric age group.