Management Outcomes in Pediatric Keratoconus: Childhood Keratoconus Study.

Area of Science:

• Ophthalmology
• Corneal Diseases
• Pediatric Eye Care

Background:

• Keratoconus (KC) management guidelines were established in 2015.
• This study evaluates treatment outcomes for pediatric KC patients.

Purpose of the Study:

• To assess the effectiveness of various management strategies in pediatric keratoconus.
• To evaluate visual acuity, refractive error, and corneal biomechanics post-treatment.

Main Methods:

• A prospective, interventional study included 116 eyes of 62 pediatric KC patients (<18 years).
• Treatments included glasses, contact lenses (CLs), corneal collagen crosslinking (CXL), deep anterior lamellar keratoplasty (DALK), and penetrating keratoplasty (PK).
• Outcomes were measured by best corrected visual acuity (BCVA), manifest cylinder, keratometry, corneal thickness, higher order aberrations, and corneal hysteresis at baseline and 24 months.

Main Results:

• 32.8% of eyes achieved satisfactory BCVA with glasses/CLs.
• CXL was performed in 43.1% of eyes with progressive KC; 83.3% showed halted progression at 2 years.
• DALK and PK were successful in 9.5% and 6.9% of eyes, respectively, with good BCVA outcomes.

Conclusions:

• Pediatric KC management using established guidelines shows good clinical utility.
• Corneal collagen crosslinking (CXL) effectively halts progression and improves visual and aberrometric outcomes.
• DALK and PK offer favorable results for pediatric keratoconus management.