ESCRS - PO567 - Biomechanical Characteristics Of The Cornea In Pediatric And Adult Keratoconus

Biomechanical Characteristics Of The Cornea In Pediatric And Adult Keratoconus

Published 2025 - 43rd Congress of the ESCRS

Reference: PO567 | Type: Free paper | DOI: 10.82333/bdac-nf54

Authors: Lucas Nicola Steinmüller* 1 , Eckart Bertelmann 1 , Jessica Stabel 1

1Department of Ophthalmology,Charité - Universitätsmedizin Berlin,Berlin,Germany

Purpose

To analyze the topographic, tomographic, and biomechanical parameters of the cornea in pediatric and adult patients with early-stage keratoconus and evaluate their correlation with patient age.

Setting

The study was conducted at Fedorov Eye Microsurgery Institution, analyzing preoperative diagnostic data of keratoconus (KC) patients of different age groups from 2022 to 2024. A total of 98 patients were divided into 3 groups based on age and KC stage according to the Amsler-Krumeich KC classification. Standard ophthalmic examinations were performed, including Scheimpflug imaging, OCT corneal pachymetry, and keratotopography.

Methods

Patients were categorized into:

  • Group 1: 30 patients (<18 years) (40 eyes) with stage 1 KC
  • Group 2: 28 patients (>18 years) (40 eyes) with stage 1 KC
  • Group 3: 40 patients (>18 years) (40 eyes) without KC

 

Key parameters assessed included corneal stiffness (SP-A), Ambrosio relational thickness (ARTh), inverse concave radius (IntRadius), deformation amplitude ratio (DA Ratio), and corneal pachymetry. Data were analyzed using SPSS software, employing Shapiro-Wilk tests for normality, ANOVA for normally distributed data, and the Mann-Whitney U-test for non-parametric comparisons.

Results

  • No statistically significant differences were found between OCT and Pentacam measurements, validating the use of Pentacam for further analysis.
  • Younger patients exhibited significantly lower corneal stiffness (SP-A1) and higher posterior elevation, with statistically significant differences (p<0.05).
  • IntRadius values were higher in children (27.4% increase in stage 1, 14.1% in stage 2, p<0.05).
  • DA Ratio was significantly lower in children, indicating greater corneal deformability.
  • Confocal microscopy showed a looser stromal structure and lower keratocyte density in children compared to adults.

Conclusions

Keratoconus progression exhibits distinct biomechanical differences between children and adults, with pediatric patients demonstrating increased corneal deformability and lower stiffness. These findings emphasize the necessity of early diagnosis and age-specific treatment strategies to prevent disease progression and optimize surgical outcomes. The study highlights the importance of incorporating biomechanical assessment in routine keratoconus management.