Corneal Collagen Cross Linking For Progressive Keratoconus In Paediatric Patients: Up To 14 Years Of Follow Up.

Published 2023 - 41st Congress of the ESCRS

Reference: FP02.04 | Type: Free paper | DOI: 10.82333/4m8c-bz11

Authors: Riccardo Vinciguerra* ¹

¹Humanitas San Pio X,Milano,Italy

Purpose

To assess the long-term outcomes of corneal collagen cross linking according to the Dresden protocol (S-CXL) in progressive pediatric keratoconus (KC).

Setting

Humanitas Clinical and Research Center, Rozzano,Italy

Methods

patients below 18 years of age who underwent to S-CXL from June 2007 to January 2011 in Humanitas Clinical and Research Center, Rozzano, (MI), Italy and completed at least 10 years of follow-up were included. Corrected distance visual acuity (CDVA), refraction, tomography with Pentacam (OCULUS, Wetzlar, Germany) were evaluated at baseline and 10+years after S-CXL. Definition of progression was 2/3 criteria of the following: progression above 95% Confidence Interval for post-CXL population of “A” or “B” values or decrease of minimal thickness evaluated with the ABCD display.

Results

Thirty-eight eyes of 24 patients fulfilled inclusion criteria. At a mean of 11.6 years post-op (maximum 14 years)

, CDVA improved significantly (from 0.703 ± 0.2625 Snellen to 0.887 ± 0.1711, p < 0.001). Similarly, A value significantly improved from 2.5503 ± 1.709 to 1.6271 ± 1.63792 (p = 0.019). Thirteen eyes (34%) showed significant post-operative progression according to B and C. Of those,

only 3 eyes (7.9%) of 3 patients progressed in terms of an increase in A.

Conclusions

S-CXL confirmed to be a safe treatment for progressive KC in paediatric patients with an anterior curvature progression rate of up to 7.9% at 10+ years of follow-up.

We suggest and validate a new definition of progression after CXL which evaluates anterior, posterior curvature and with thickness map together with the knowledge of the noise level of the testing system.