Ophthalmology Department, Faculty of Medicine, Van Yuzuncu Yil University, Tuşba/Van, Turkey.
Cornea. 2019 Aug;38(8):992-997. doi: 10.1097/ICO.0000000000001975.
To report long-term results of accelerated corneal collagen cross-linking treatment in patients with progressive keratoconus in the pubertal period.
Patients with progressive keratoconus aged 14 and younger were retrospectively reviewed. Thirty-five eyes of 23 patients, who were followed for at least 4 years postoperatively, were included in the study. Demographic characteristics, uncorrected visual acuity, best-corrected visual acuity, and corneal topography data were recorded. All patients underwent an epi-off accelerated corneal collagen cross-linking protocol.
The mean age of the participants was 13 ± 0.5 (11-14) years. Male to female ratio was 3/2. The mean pupillary center to cone apex distance was 1.6 ± 0.5 mm. At presentation, 11 eyes (31%) were classified as stage 1 keratoconus; 14 eyes (40%) were classified as stage 2 keratoconus, 8 eyes (23%) were classified as stage 3 keratoconus, and 2 eyes (6%) were classified as stage 4 keratoconus. The mean follow-up period was 56 ± 8 months. At the first year of the follow-up, central corneal thickness (CCT) and thickness of thinnest point of the cornea (TTPC) were found to be decreased significantly in comparison to preoperative values (P = 0.02 and P = 0.003, respectively). At the second year of follow-up, only TTPC was found to be decreased in comparison to preoperative value (P = 0.01). At the last follow-up visit, CCT was found to be increased significantly in comparison to preoperative CCT (P = 0.04).
After an average follow-up of 56 months, progression was determined in 20% of the eyes despite appropriate treatment. In the last visit, progression was found to be associated with K1, K2, CCT, TTPC, and age.
报告青春期进展性圆锥角膜患者加速角膜胶原交联治疗的长期结果。
回顾性分析进展性圆锥角膜患者，年龄 14 岁及以下，术后至少随访 4 年。记录患者的人口统计学特征、未矫正视力、最佳矫正视力和角膜地形图数据。所有患者均行上皮下加速角膜胶原交联术。
共纳入 23 例患者的 35 只眼，平均年龄为 13±0.5 岁（11~14 岁），男女比例为 3:2。瞳孔中心至圆锥顶点的平均距离为 1.6±0.5mm。就诊时，11 只眼（31%）为 1 期圆锥角膜，14 只眼（40%）为 2 期，8 只眼（23%）为 3 期，2 只眼（6%）为 4 期。平均随访时间为 56±8 个月。随访第 1 年，与术前相比，中央角膜厚度（CCT）和角膜最薄点厚度（TTPC）显著降低（P=0.02 和 P=0.003）。随访第 2 年，与术前相比，仅 TTPC 降低（P=0.01）。末次随访时，CCT 与术前 CCT 相比显著增加（P=0.04）。
平均随访 56 个月后，尽管进行了适当治疗，仍有 20%的眼出现进展。在末次随访中，进展与 K1、K2、CCT、TTPC 和年龄有关。
