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Middle East African Journal of Ophthalmology Middle East African Journal of Ophthalmology
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ORIGINAL ARTICLE
Year : 2019  |  Volume : 26  |  Issue : 2  |  Page : 95-100

Safety and efficacy of corneal cross-linking in pediatric patients with keratoconus and vernal keratoconjunctivitis


1 Cornea and Anterior Segment Division, King Khaled Eye Specialist Hospital; Division of Ophthalmology, King Abdulaziz Medical City, Riyadh, Saudi Arabia
2 Jeddah Eye Hospital, Jeddah, Saudi Arabia
3 College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
4 Cornea and Anterior Segment Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
5 Cornea and Anterior Segment Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia; Wilmer Eye Institute, Johns Hopkins University, Baltimore, MD, USA

Correspondence Address:
Dr. Donald U Stone
427 S. Bernard Street, Spokane, Washington 99204

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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/meajo.MEAJO_240_18

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PURPOSE: The purpose of the study is to determine the safety and efficacy of corneal collagen cross-linking for keratoconus in pediatric patients with and without vernal keratoconjunctivitis (VKC). METHODS: This is a retrospective analysis of 89 eyes of 58 patients <18 years of age that underwent corneal collagen cross-linking for progressive keratoconus; inclusion criteria included a minimum of 2-year follow-up after cross-linking. The main outcomes measures included keratometry, pachymetry, vision, and complications following epithelial-off cross-linking with the Dresden protocol. RESULTS: VKC patients were more likely to be male; 81.6% of the non-VKC patients and 96.3% of VKC patients were male (P = 0.038). Comparing pretreatment to the 2-year follow-up, there was no statistically significant change in the mean steep or flat keratometry, corneal thickness, and uncorrected visual acuity or best spectacle-corrected visual acuity in either group. There were no statistically significant differences in the mean visual, keratometric, or adverse event outcomes between the two groups. The proportion exhibiting progression of ectasia at 2 years was 18.5% in the VKC group and 16.7% in the non-VKC group (P = 0.83). CONCLUSIONS: Cross-linking appears to be as safe and effective in pediatric patients with vernal keratoconjunctivits as in those without, with similar outcomes, adverse events, and progression of keratoconus after treatment. The proportion of patients exhibiting progression appears to be higher in pediatric patients than adults, and there is an association between male sex and diagnosis of VKC.


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