Technique for pediatric corneal crosslinking under general anesthesia.

Area of Science:

• Ophthalmology
• Surgical Techniques

Background:

• Corneal cross-linking (CXL) is standard for treating progressive corneal ectasias.
• Topical anesthesia for CXL is challenging in pediatric and uncooperative patients.

Purpose of the Study:

• To describe a novel technique for performing CXL under general anesthesia.
• To introduce a time-saving bilateral simultaneous CXL procedure.
• To evaluate the safety and efficacy in pediatric patients.

Main Methods:

• CXL performed under sevoflurane and propofol general anesthesia.
• Eye stabilization using laryngeal airway/nasal oxygen cannulas and forceps/microsponges.
• Bilateral simultaneous CXL performed in a staggered manner.
• Multimodal analgesia administered postoperatively.

Main Results:

• 21 eyes of 13 pediatric subjects (≤18 years) treated.
• Median follow-up of 14.5 months.
• One case of sterile corneal infiltrate, resolved with corticosteroids.
• Up to 25% reduction in surgical time achieved.

Conclusions:

• General anesthesia CXL is a viable and safe option for pediatric patients.
• Bilateral simultaneous CXL is efficient, reducing operative time.
• The technique ensures patient comfort and minimizes complications.