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Clinical and topographic effects of combined ICRS implantation and cross-linking with respect to patient age

Poster Details

First Author: S.el-Khoury LEBANON

Co Author(s):    M. Amro   K. Zaarour   Y. Abdelmassih   E. Jarade           

Abstract Details

Purpose:

To assess the corneal remodeling effect after sequential intracorneal ring segment implantation (ICRS) and crosslinking (CXL) with correlation to age. Information about the behavior of the cornea of children after surgery is important in guiding clinicians for the treatment of keratoconus and other corneal diseases in children.

Setting:

Beirut Eye Specialist Hospital, Beirut, Lebanon

Methods:

This is a retrospective matched case-control series including 26 eyes of patients �â�‰�¤18 years matched with 26 eyes of adult patients. All eyes received ICRSॲ� for keratoconus. Each eye of a young patient was matched for type of ICRS (Keraring / Intacs), number of ring segments (1 or 2), thickness (210�Î�¼m to 450�Î�¼m) and Kmax with one eye of an adult patient. Maximum possible age difference between patients was chosen. Data was analyzed for refractive and topographic values (UDVA; CDVA; sphere; cylinder; spherical equivalent; Kmax; Kflat; Ksteep; and all 7 topographic indices) preoperatively and 1 year postoperatively.

Results:

Preoperatively, there was no significant difference for any refractive, clinical or topographic parameter between groups. At one year, children had a significantly higher improvement in Ksteep (3.05D) than adults (2.10D; P=0.036) and a trend to significance for Kflat (2.7D compared to 1.78D, respectively; P=0.081). UDVA improved in children by 4.3 ETDRS lines compared to 3.3 ETDRS lines in adults and CDVA improved by 1.7 ETDRS lines in children compared to 1.2 ETDRS lines in adults, but with no statistical significance. These effects remain if percentages are calculated. Keratoconus indices showed no significant differences between groups.

Conclusions:

Effects on K-readings indicate that corneal remodeling after ICRS and CXL for keratoconus is more pronounced in young patients then in adults. This assumption is supported by data on functional improvement. Despite keratoconus indices showing no statistical differences, we observed that a few eyes (5) of some very young patients (<13 years) showed highly remarkable improvements after surgery (higher than any adult eye). Therefore, we advise keratoconus treatment to be performed as early as possible and advocate for more awareness towards early manifestation of keratoconus.

Financial Disclosure:

NONE

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