Keratokonuslu Çocuklarda Korneal Çapraz Bağlama Tedavisinin Güvenilirlik ve Etkinliği

Amaç: Keratokonuslu çocuklarda korneal çapraz bağlama (CXL) tedavisinin güvenilirlik ve etkinliğini değerlendirmek. Materyal ve metod: Bu çalışmaya ilerleyici keratokonuslu 34 çocuğun 45 gözü dahil edildi. CXL, geleneksel yönteme göre uygulandı. Manifest kırılma, düzeltilmemiş uzak görme keskinliği (UDVA), düzeltilmiş uzak görme keskinliği (CDVA), korneal topografi değerleri ve endotel hücre yoğunluğu (ECD) başlangıçta, 12 ve 24 aylık takiplerde değerlendirildi. Bulgular: Hastaların ortalama yaşı 14.6 ± 3.5 yıldı. Ortalama sferik eşdeğer değerler, 12 ve 24 aylık vizitlerde istatistiksel olarak anlamlı şekilde azaldı (sırasıyla p= 0.039, p=0.016). Ortalama UDVA ve CDVA'da 12 (sırasıyla p=0,003, p=0,005) ve 24 aylık (sırasıyla p=0.002, p=0.006) vizitlerde anlamlı bir iyileşme vardı. Ortalama K1 ve K2 ameliyat sonrası 12. ayda (sırasıyla p=0.013, p=0.012) ve 24. ayda (sırasıyla p=0.004, p=0.006) istatistiksel olarak anlamlı şekilde azaldı. Herhangi bir takip muayenesinde ECD'de önemli bir değişiklik olmadı. Görmeyi tehdit eden önemli bir komplikasyon gözlenmedi. Sonuç: CXL prosedürü, 24 aylık takip süresi içinde çocuklarda keratokonus progresyonunu stabilize etmede güvenli ve etkili görünmektedir.

Anahtar Kelimeler:

keratokonus, kornea çapraz bağlanması, pediatrik keratokonus

Safety and Efficacy of Corneal Crosslinking Treatment in Children with Keratoconus

Background: To evaluate the safety and efficacy of corneal crosslinking (CXL) treatment in children with keratoconus. Materials and Methods:A total of 45 eyes of 34 children with progressive keratoconus were included in this study. CXL was performed according to the conventional method. Manifest refraction, uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), corneal topography values, and endothelial cell density (ECD) were evaluated at baseline and 24-month follow-up. Results:The mean age of the patients was 14.6 ± 3.5 years. The mean spherical equivalent readings were statistically significantly decreased at 24 months (p=0.016). There was a significant improvement in the mean UDVA and CDVA at 24 months (p=0.002, p=0.006, respectively). The mean K1 and K2 were statistically significantly reduced at 24 months postoperatively (p=0.004, p=0.006, respectively). There was no significant alteration in ECD at any follow-up examination. No significant sight-threatening complications were observed. Conclusions: The CXL procedure seem to be safe and effective in stabilizing keratoconus progression in children within a follow-up of 24 months.

Keywords:

keratoconus, corneal crosslinking, pediatric keratoconus,

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