Corneal crosslinking efficacy in patients with keratoconus under 18 years of age

ABSTRACT Purpose: Keratoconus presents certain specificities in pediatric patients compared with adults. The greatest challenge is because the disease is typically more severe and progresses faster in children. This retrospective study aimed to report crosslinking procedure in patients under 18 years of age and their follow-up for at least 24 months after the procedure. Methods: Overall, 12 eyes from 10 patients were studied and data, such as visual acuity with and without correction, maximum keratometry, corneal thickness, foveal thickness, and endothelial microscopy, were assessed at both preoperative and postoperative visits. Corneal crosslinking was performed in all patients. Results: A tendency toward reduced Kmax and improved Corrected Distance Visual Acuity at all postoperative moments. Only one of the 12 eyes exhibited increased Kmax of more than 1 D during a time frame longer than 12 months. Regarding pachymetry, a tendency for corneal thinning was observed in the first four months after surgery. Conclusion: Encouraging results were obtained regarding the stabilization of the disease, progression, and procedural safety, corroborating to other authors’ findings. The significance of early diagnosis and short-term follow-up were highlighted.

摘要
目的：圆锥角膜（Keratoconus）在儿科患者中与成人相比存在特异性差异。其临床诊治的最大难点在于，该疾病在儿童群体中通常更为严重且进展更快。本回顾性研究旨在报告18岁以下患者接受角膜交联术（corneal crosslinking）的临床情况，并对其术后至少24个月的随访结果进行分析。
方法：本研究共纳入10例患者的12只患眼，在术前及术后所有随访节点均对多项指标进行评估，包括裸眼视力与矫正视力、最大角膜曲率（maximum keratometry）、角膜厚度、黄斑中心凹厚度（foveal thickness）以及角膜内皮显微镜检查（endothelial microscopy）结果。所有患者均接受了角膜交联手术。
结果：术后各随访节点均呈现出最大角膜曲率（Kmax）降低、矫正远视力改善的趋势。12只患眼中仅1只在术后超过12个月的随访周期内出现Kmax升高超过1屈光度（D）的情况。在角膜测厚结果方面，术后前4个月观察到角膜变薄的趋势。
结论：本研究在疾病病情稳定、进展控制及手术安全性方面均取得了令人鼓舞的结果，与其他学者的研究结论相符。研究强调了早期诊断与短期随访的重要临床意义。