Alrobaian Malek, Elsayed Maram, Alotaibi Abdulaziz Khalid, AlHarbi Mosa, May William, Stone Donald U
Cornea and Anterior Segment Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia.
Division of Ophthalmology, King Abdulaziz Medical City, Riyadh, Saudi Arabia.
Middle East Afr J Ophthalmol. 2019 Aug 26;26(2):95-100. doi: 10.4103/meajo.MEAJO_240_18. eCollection 2019 Apr-Jun.
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).
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.
VKC patients were more likely to be male; 81.6% of the non-VKC patients and 96.3% of VKC patients were male ( = 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 ( = 0.83).
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.
本研究旨在确定角膜交联术治疗患有和未患有春季角结膜炎（VKC）的小儿圆锥角膜患者的安全性和有效性。
这是一项对58例18岁以下因进行性圆锥角膜接受角膜交联术的患者的89只眼睛进行的回顾性分析；纳入标准包括交联术后至少2年的随访。主要观察指标包括角膜曲率测量、角膜厚度测量、视力以及采用德累斯顿方案进行上皮去除交联术后的并发症。
VKC患者更可能为男性；非VKC患者中81.6%为男性，VKC患者中96.3%为男性（P = 0.038）。比较术前与2年随访结果，两组的平均陡峭或平坦角膜曲率、角膜厚度、未矫正视力或最佳眼镜矫正视力均无统计学显著变化。两组之间的平均视力、角膜曲率测量或不良事件结果无统计学显著差异。VKC组2年时出现角膜扩张进展的比例为18.5%，非VKC组为16.7%（P = 0.83）。
角膜交联术在患有春季角结膜炎的小儿患者中似乎与未患该病的小儿患者一样安全有效，治疗后圆锥角膜的结果、不良事件及进展情况相似。小儿患者中出现进展的患者比例似乎高于成人，并且男性性别与VKC诊断之间存在关联。
