Corneal collagen cross-linking treatment results and demographiccharacteristics in pediatric keratoconus patients

Objective: To determine the efficacy and safety of accelerated collagen crosslinking treatment in pediatric patients diagnosed with keratoconus. Materials and Methods: Between 2014 and 2019, 229 eyes of 146 patients aged 16 years and younger with keratoconus who applied to the corneal unit were included in the study. In the preoperative and postoperative 1st, 3rd, 6th and 12th months of all patients participating in the study best corrected visual acuity (BCVA), spherical and cylindrical values, topografic straight keratometric value (K1), vertical keratometric value (K2), the steepest keratometric value (Kmax), the thinnest corneal thickness (TCT) values were recorded. In addition, eye diseases and systemic diseases accompanying keratoconus were noted. Results: The mean age of the patients included in the study was 14.10±1.94 years. Of 146 patients, 65 (44.5%) were female and 81 (55.5%) were male. While the mean BCVA of the patients was 0.39±0.56 logMAR preoperatively; they were 0.37±0.58, 0.36±0.58 and 0.35±0.58 logMAR respectively at the 3rd month, 6th month and 1st year postoperatively. While the mean spherical value was -2.86±3.70 preoperatively, it was measured -3.57±4.18, -3.30±3.93 and -3.59±4.17 at the 3rd month, 6th month and 1st year postoperatively. While the mean cylindrical value was -3.67±2.20 preoperatively, it was - 4.38±2.18, -4.0±1.96 and -4.58±2.34 respectively at the 3rd month, 6th month and 1st year postoperatively. While the mean cylindrical axis value was 93.71±65.07 preoperatively, it was determined 86.42±68.57, 92.38±67.34 and 94.85±68.21 respectively at the 3rd month, 6th month and 1st year postoperatively. While the calculated mean spherical equivalent was -4.87±4.15 preoperatively, it was -5.84±4.67, -5.45±4.40, and -5.97±4.70 at the 3rd month, 6th month and 1st year postoperatively. When preoperatively, the mean K1 value measured on the tomography device (pentacam) was 46.419±3.81; postoperatively, it was determined 46.073±3.74 (1st month ), 46.254±4.07 (3rd month), 46.146±3.78 (6th month ) and 46.175±3.89 (1st year ). While the mean preoperative to K2 value was 50,443±4.43, postoperative it was 50.026±4.31 at the 1st month, 3rd month, 6th month and 1st year, respectively; 50,303±4.70; 50.301±4.56 and 50.341±4.48. While the mean preoperative Kmax value was 54.183±6.22, postoperatively it was determined 54.705±5.97 at 1st month, 54,742±6.62 at 3rd month, 54.561±6.46 at 6th month and 54.600±6.46 at 1st year.While the mean preoperative TCT value was 447.29±49.59, postoperatively it was determined 411.75±85.79 at 1st month, 423.13±72.04 at 3rd month, 439.04±57.17 at 6th month and 441.83±49.44 at 1st year. In patients, other eye diseases and systemic diseases accompanying keratoconus were evaluated. The keratoconus accompanied by allergic conjunctivitis was determined in 30.8% of the patients. Conclusion According to the results of our study; Collagen cross-linking treatment applied in childhood stopped the progression of keratoconus at the same time provided a slight increase in vision. In addition, allergic conjunctivitis was the most common accompanied systemic disease. Key Words: Pediatric keratoconus patients, corneal collagen cross-linking