Outcomes of accelerated corneal cross-linking for pediatric and adult keratoconus: a comparative study
Purpose To compare the visual, refractive, and topographic outcomes of a high irradiance accelerated corneal crosslinking (ACXL) protocol after a 12-month follow-up between pediatric and adult patients with progressive keratoconus (KC). Methods Retrospective, comparative, cohort study. Patients with KC were divided into two groups: pediatric (≤ 18 years) and adult (> 18 years). All of them were managed with epi-OFF ACXL (30 mW/$ cm^{2} $, 8 min, pulsed 1:1 on and off = 7.2 J/$ cm^{2} $). Visual, refractive, and topographic values were measured preoperatively and at 1, 3, 6, and 12 months postoperative. KC progression, defined as a $ K_{max} $ increase of ≥ 1D during follow-up, was recorded. Results Eighty-nine eyes (53 patients) were included for analysis; 45 (50.6%) eyes were from pediatric patients and 44 (49.4%) from adults. At one-year follow-up, pediatric patients experienced significantly higher rates of progression (22.2% vs. 4.5%, p = .014). Contrariwise, female gender (Beta = − 3.62, p = .018), a baseline uncorrected visual acuity of Snellen ≥ 20/60 (Beta = − 5.96, p = .007), and being ≥ 15 years at ACXL treatment (Beta = − 0.31, p = .021) were associated with non-progressive disease. A significant improvement in best-corrected visual acuity, $ K_{min} $, $ K_{m} $, and $ K_{max} $ was recorded in both groups. Overall, 86.5% of eyes from both groups showed $ K_{max} $ stabilization or improvement. Conclusions Despite the similarity in visual, refractive, and topographic outcomes in both groups, younger age was associated with KC progression after ACXL at one year of follow-up..
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:44 |
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| Enthalten in: |
International ophthalmology - 44(2024), 1 vom: 18. März |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Bustamante-Arias, Andres [VerfasserIn] |
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| Links: |
Volltext [lizenzpflichtig] |
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| BKL: | |
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| Themen: |
Accelerated corneal crosslinking |
| Anmerkungen: |
© The Author(s), under exclusive licence to Springer Nature B.V. 2024. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. |
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| doi: |
10.1007/s10792-024-03080-2 |
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| 520 | |a Purpose To compare the visual, refractive, and topographic outcomes of a high irradiance accelerated corneal crosslinking (ACXL) protocol after a 12-month follow-up between pediatric and adult patients with progressive keratoconus (KC). Methods Retrospective, comparative, cohort study. Patients with KC were divided into two groups: pediatric (≤ 18 years) and adult (> 18 years). All of them were managed with epi-OFF ACXL (30 mW/$ cm^{2} $, 8 min, pulsed 1:1 on and off = 7.2 J/$ cm^{2} $). Visual, refractive, and topographic values were measured preoperatively and at 1, 3, 6, and 12 months postoperative. KC progression, defined as a $ K_{max} $ increase of ≥ 1D during follow-up, was recorded. Results Eighty-nine eyes (53 patients) were included for analysis; 45 (50.6%) eyes were from pediatric patients and 44 (49.4%) from adults. At one-year follow-up, pediatric patients experienced significantly higher rates of progression (22.2% vs. 4.5%, p = .014). Contrariwise, female gender (Beta = − 3.62, p = .018), a baseline uncorrected visual acuity of Snellen ≥ 20/60 (Beta = − 5.96, p = .007), and being ≥ 15 years at ACXL treatment (Beta = − 0.31, p = .021) were associated with non-progressive disease. A significant improvement in best-corrected visual acuity, $ K_{min} $, $ K_{m} $, and $ K_{max} $ was recorded in both groups. Overall, 86.5% of eyes from both groups showed $ K_{max} $ stabilization or improvement. Conclusions Despite the similarity in visual, refractive, and topographic outcomes in both groups, younger age was associated with KC progression after ACXL at one year of follow-up. | ||
| 650 | 4 | |a Keratoconus |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Corneal ectasia |7 (dpeaa)DE-He213 | |
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| 700 | 1 | |a Ruiz-Lozano, Raul E. |0 (orcid)0000-0001-7022-2395 |4 aut | |
| 700 | 1 | |a Rodriguez-Gutierrez, Luis A. |4 aut | |
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