Corneal collagen cross-linking in paediatric patients affected by keratoconus

KA Knutsson, G Paganoni, S Matuska, O Ambrosio, G Ferrari, A Zennato, M Caccia, P Rama

Research output: Contribution to journalArticle

Abstract

Background/aims: To evaluate the effectiveness of corneal collagen cross-linking (CXL) in paediatric patients.Methods: Fifty-two eyes of 43 paediatric patients with progressive keratoconus were enrolled in a prospective cohort study. Corneal CXL was performed using a conventional technique with instillation of 0.1% riboflavin solution containing dextran 20% for 30 min during the soaking phase and during the 30 min ultraviolet A irradiation (3 mW/cm2). Visual outcomes, topographic keratometry, maximum keratometry (K-max), refractive astigmatism, demarcation line and endothelial cell density were measured postoperatively.Results: A significant decrease of K-max from 59.30±7.08 to 57.07±6.46 (p <0.001) was observed 2 years after treatment. Uncorrected visual acuity improved from 0.59±0.41 LogMAR (logarithm of the minimum angle resolution) to 0.46±0.33 LogMAR (p=0.06) 2 years after the procedure, while best spectacle corrected visual acuity improved from 0.17±0.11 LogMAR to 0.15±0.12 LogMAR (p=0.17). Twenty-five eyes had K-max values of 60 dioptres (D) or greater. In this subgroup, K-max significantly decreased from 64.94±4.99 D to 62.25±4.42 D at 2 years (p <0.001). The demarcation line of the CXL treatment had a mean value of 249±74 μm and did not show a significant correlation with K-max flattening (Spearman r=0.019, p=0.899). Endothelial cell density remained stable 2 years after the procedure, changing from 2800±363 to 2736±659 cells/mm2 (p=0.90).Conclusion: CXL is an effective treatment for avoiding keratoconus progression in paediatric patients. The procedure is safe and successful in stabilising keratoconus in eyes with more advanced forms of the disease, characterised by topographic K-max values greater than 60 D. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017.
Original languageEnglish
Pages (from-to)248-252
Number of pages5
JournalBritish Journal of Ophthalmology
Volume102
Issue number2
DOIs
Publication statusPublished - 2018

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Keratoconus
Collagen
Pediatrics
Visual Acuity
Endothelial Cells
Cell Count
Astigmatism
Riboflavin
Dextrans
Cohort Studies
Therapeutics
Prospective Studies

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Corneal collagen cross-linking in paediatric patients affected by keratoconus. / Knutsson, KA; Paganoni, G; Matuska, S; Ambrosio, O; Ferrari, G; Zennato, A; Caccia, M; Rama, P.

In: British Journal of Ophthalmology, Vol. 102, No. 2, 2018, p. 248-252.

Research output: Contribution to journalArticle

Knutsson, KA ; Paganoni, G ; Matuska, S ; Ambrosio, O ; Ferrari, G ; Zennato, A ; Caccia, M ; Rama, P. / Corneal collagen cross-linking in paediatric patients affected by keratoconus. In: British Journal of Ophthalmology. 2018 ; Vol. 102, No. 2. pp. 248-252.
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abstract = "Background/aims: To evaluate the effectiveness of corneal collagen cross-linking (CXL) in paediatric patients.Methods: Fifty-two eyes of 43 paediatric patients with progressive keratoconus were enrolled in a prospective cohort study. Corneal CXL was performed using a conventional technique with instillation of 0.1{\%} riboflavin solution containing dextran 20{\%} for 30 min during the soaking phase and during the 30 min ultraviolet A irradiation (3 mW/cm2). Visual outcomes, topographic keratometry, maximum keratometry (K-max), refractive astigmatism, demarcation line and endothelial cell density were measured postoperatively.Results: A significant decrease of K-max from 59.30±7.08 to 57.07±6.46 (p <0.001) was observed 2 years after treatment. Uncorrected visual acuity improved from 0.59±0.41 LogMAR (logarithm of the minimum angle resolution) to 0.46±0.33 LogMAR (p=0.06) 2 years after the procedure, while best spectacle corrected visual acuity improved from 0.17±0.11 LogMAR to 0.15±0.12 LogMAR (p=0.17). Twenty-five eyes had K-max values of 60 dioptres (D) or greater. In this subgroup, K-max significantly decreased from 64.94±4.99 D to 62.25±4.42 D at 2 years (p <0.001). The demarcation line of the CXL treatment had a mean value of 249±74 μm and did not show a significant correlation with K-max flattening (Spearman r=0.019, p=0.899). Endothelial cell density remained stable 2 years after the procedure, changing from 2800±363 to 2736±659 cells/mm2 (p=0.90).Conclusion: CXL is an effective treatment for avoiding keratoconus progression in paediatric patients. The procedure is safe and successful in stabilising keratoconus in eyes with more advanced forms of the disease, characterised by topographic K-max values greater than 60 D. {\circledC} Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017.",
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T1 - Corneal collagen cross-linking in paediatric patients affected by keratoconus

AU - Knutsson, KA

AU - Paganoni, G

AU - Matuska, S

AU - Ambrosio, O

AU - Ferrari, G

AU - Zennato, A

AU - Caccia, M

AU - Rama, P

PY - 2018

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N2 - Background/aims: To evaluate the effectiveness of corneal collagen cross-linking (CXL) in paediatric patients.Methods: Fifty-two eyes of 43 paediatric patients with progressive keratoconus were enrolled in a prospective cohort study. Corneal CXL was performed using a conventional technique with instillation of 0.1% riboflavin solution containing dextran 20% for 30 min during the soaking phase and during the 30 min ultraviolet A irradiation (3 mW/cm2). Visual outcomes, topographic keratometry, maximum keratometry (K-max), refractive astigmatism, demarcation line and endothelial cell density were measured postoperatively.Results: A significant decrease of K-max from 59.30±7.08 to 57.07±6.46 (p <0.001) was observed 2 years after treatment. Uncorrected visual acuity improved from 0.59±0.41 LogMAR (logarithm of the minimum angle resolution) to 0.46±0.33 LogMAR (p=0.06) 2 years after the procedure, while best spectacle corrected visual acuity improved from 0.17±0.11 LogMAR to 0.15±0.12 LogMAR (p=0.17). Twenty-five eyes had K-max values of 60 dioptres (D) or greater. In this subgroup, K-max significantly decreased from 64.94±4.99 D to 62.25±4.42 D at 2 years (p <0.001). The demarcation line of the CXL treatment had a mean value of 249±74 μm and did not show a significant correlation with K-max flattening (Spearman r=0.019, p=0.899). Endothelial cell density remained stable 2 years after the procedure, changing from 2800±363 to 2736±659 cells/mm2 (p=0.90).Conclusion: CXL is an effective treatment for avoiding keratoconus progression in paediatric patients. The procedure is safe and successful in stabilising keratoconus in eyes with more advanced forms of the disease, characterised by topographic K-max values greater than 60 D. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017.

AB - Background/aims: To evaluate the effectiveness of corneal collagen cross-linking (CXL) in paediatric patients.Methods: Fifty-two eyes of 43 paediatric patients with progressive keratoconus were enrolled in a prospective cohort study. Corneal CXL was performed using a conventional technique with instillation of 0.1% riboflavin solution containing dextran 20% for 30 min during the soaking phase and during the 30 min ultraviolet A irradiation (3 mW/cm2). Visual outcomes, topographic keratometry, maximum keratometry (K-max), refractive astigmatism, demarcation line and endothelial cell density were measured postoperatively.Results: A significant decrease of K-max from 59.30±7.08 to 57.07±6.46 (p <0.001) was observed 2 years after treatment. Uncorrected visual acuity improved from 0.59±0.41 LogMAR (logarithm of the minimum angle resolution) to 0.46±0.33 LogMAR (p=0.06) 2 years after the procedure, while best spectacle corrected visual acuity improved from 0.17±0.11 LogMAR to 0.15±0.12 LogMAR (p=0.17). Twenty-five eyes had K-max values of 60 dioptres (D) or greater. In this subgroup, K-max significantly decreased from 64.94±4.99 D to 62.25±4.42 D at 2 years (p <0.001). The demarcation line of the CXL treatment had a mean value of 249±74 μm and did not show a significant correlation with K-max flattening (Spearman r=0.019, p=0.899). Endothelial cell density remained stable 2 years after the procedure, changing from 2800±363 to 2736±659 cells/mm2 (p=0.90).Conclusion: CXL is an effective treatment for avoiding keratoconus progression in paediatric patients. The procedure is safe and successful in stabilising keratoconus in eyes with more advanced forms of the disease, characterised by topographic K-max values greater than 60 D. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017.

U2 - 10.1136/bjophthalmol-2016-310108

DO - 10.1136/bjophthalmol-2016-310108

M3 - Article

VL - 102

SP - 248

EP - 252

JO - British Journal of Ophthalmology

JF - British Journal of Ophthalmology

SN - 0007-1161

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ER -