Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, Florida, USA.
Indian J Ophthalmol. 2013 Aug;61(8):435-40. doi: 10.4103/0301-4738.116070.
Pediatric keratoconus demonstrates several distinctive management issues in comparison with adult keratoconus with respect to under-diagnosis, poor compliance and modifications in treatment patterns. The major concerns comprise of the accelerated progression of the disease in the pediatric age group and management of co-morbidities such as vernal keratoconjuntivitis. Visual impairment in pediatric patients may affect social and educational development and overall negatively impact their quality of life. The treatment algorithm between adults and pediatric keratoconus has been similar; comprising mainly of visual rehabilitation with spectacles, contacts lenses (soft or rigid) and keratoplasty (lamellar or penetrating) depending on the stage of the disease. There is a paradigm shift in the management of keratoconus, a new treatment modality, corneal collagen crosslinking (CXL), has been utilized in adult keratoconic patients halting the progression of the disease. CXL has been utilized for over a 10 year period and based on the evidence of efficacy and safety in the adult population; this treatment has been recently utilized in management of pediatric keratoconus. This article will present an update about current management of pediatric keratoconus with special focus on CXL in this age group.
与成人圆锥角膜相比，小儿圆锥角膜在诊断不足、治疗顺应性差和治疗模式改变等方面存在一些独特的管理问题。主要关注点包括疾病在儿童期的快速进展以及与春季角结膜炎等共存疾病的管理。小儿患者的视力损害可能会影响其社交和教育发展，并对其生活质量产生整体负面影响。成人和小儿圆锥角膜的治疗方案相似，主要包括视力康复治疗，包括眼镜、隐形眼镜（软性或硬性）和角膜移植术（板层或穿透），具体取决于疾病的阶段。圆锥角膜的管理模式发生了转变，一种新的治疗方法——角膜胶原交联术（CXL）已被用于阻止成人圆锥角膜患者的病情进展。CXL 已被用于成人超过 10 年，并且基于在成人人群中的疗效和安全性证据，这种治疗方法最近已被用于小儿圆锥角膜的管理。本文将介绍小儿圆锥角膜的当前管理方法的最新进展，特别关注该年龄段的 CXL。
