Corneal CXL in Children With Progessive Keratoconus Author do not have any financial interest in the surgical procedure or the medicines used in this study Authors Ashok Sharma, Cornea Centre, Chandigarh, India Verinder S Nirankari, Eye Consultants of Maryland
To present visual, refractive and topographic outcome after corneal cross-linking (CXL) for progressive keratoconus in children below 18 years Purpose
Patients & Methods Study Design: A retrospective non-comparative interventional case series Patients with progressive keratoconus aged below 18 years treated with CXL Data on pre & post CXL mean Sim K, spherical equivalent, cylinder, UCVA and BCVA retrived and analysed CCT > than 400 microns in all eyes No intra-operative complications were noted Mean follow-up: ± 10.5 months.
Surgical Procedure Dresden protocol CXL with instrument calibration before each treatment Epithelium off technique Intra operative pachymetery Un-cooperative children and those below 12 years under general anaesthesia
Corneal CXL : Pre-op Data K1: 46.36±3.49 K2: 50.66±4.56 Km: 48.36±3.72 BCVA : 0.06±0.12 Astig : 4.13±2.02D Pachy: 453±36 µ Pre-op Corneal Topography
CXL : Results Keratoconus stable : 29(91%) eyes One eye developed corneal hydrops One showed progression topography Another showed significant decrease in corneal thickness
Corneal CXL : Pre-op vs Post-op Sim K Mean pre-op vs post-op Sim K (p>0.05)
Pre and Post CXL Topography Pre-CXL Post-CXL
Mean Pre-op and Post-op Mean Spherical Equivalent (MSE) & Cylinder
Mean pre-op & post-op UCVA & BCVA LogMAR VA
Post-CXL: Complications Persistent corneal haze > 3 weeks: Nil Persistent epithelial defect > 72 hrs: 3 eyes Sterile infiltrates: Nil Infective keratitis: Nil Pre-op vs post-op endothelial cells (p<0.05)
Conclusions Cornea Collagen Crosslinking : Safe & effective in stabilizing keratoconus in children