Outcome indicators for cross linking in pediatric keratoconus

Area of Science:

• Ophthalmology
• Corneal Surgery
• Pediatric Eye Care

Background:

• Keratoconus (KC) is a progressive corneal ectasia affecting pediatric patients.
• Corneal collagen cross-linking (CXL) is a standard treatment to halt KC progression.
• Predictive factors for CXL success in pediatric KC require further elucidation.

Purpose of the Study:

• To identify predictive factors for successful corneal collagen cross-linking (CXL) in pediatric patients diagnosed with keratoconus (KC).
• To analyze the impact of various clinical and treatment parameters on CXL outcomes in children.

Main Methods:

• Retrospective analysis of a prospectively built database of pediatric KC patients (≤18 years) undergoing CXL.
• Evaluation of outcomes including changes in maximal corneal power (Kmax) and LogMAR visual acuity.
• Statistical analysis of factors such as CXL type, age, sex, ocular allergy, ethnicity, preoperative visual acuity, corneal power, pachymetry, and follow-up duration.

Main Results:

• Corneal collagen cross-linking (CXL) demonstrated significant improvement in Kmax and LogMAR visual acuity in pediatric KC patients.
• Univariate analysis indicated that longer follow-up, lower preoperative central corneal thickness, higher preoperative Kmax, higher preoperative LogMAR visual acuity, and non-accelerated CXL were associated with corneal flattening.
• Multivariate analysis identified higher preoperative Kmax and non-accelerated CXL as significant predictors of corneal flattening.

Conclusions:

• Corneal collagen cross-linking (CXL) is an effective therapeutic option for pediatric keratoconus (KC).
• Non-accelerated CXL appears to be more effective than accelerated CXL in this pediatric cohort.
• Corneas with more advanced disease stages may exhibit a more pronounced positive response to CXL treatment.