Pediatrik Keratokonus Vakalarında Transepitelyal Cross-linking Tedavisinin Etkinliği

GİRİŞ ve AMAÇ: Pediatrik keratokonusta transepitelial korneal kollajen crosslinking (CXL) tedavisinin etkinliğinin klinik izlemlerimiz ve literatür bilgileri ışığında değerlendirilmesi amaçlanmıştır YÖNTEM ve GEREÇLER: 2015-2016 yılları arasında Kocaeli Üniversitesi Tıp Fakültesi Göz Hastalıkları'na başvurup progressif keratokonus tanısıyla CXL tedavisi uygulanmış ve en az bir yıl takip edilmiş 18 yaş altı 18 hastanın 33 gözü, retrospektif olarak incelendi. CXL öncesi ve postoperatif 1, 3, 6 ve 12. aylardaki en iyi düzeltilmiş görme keskinliği (EİDGK) ve Sirius topografi cihazı ile kaydedilen; merkezi kornea kalınlığı (MKK), en ince lokalizasyondaki kornea kalınlığı (EİKK), keratometrik değerler [simüle düz keratometri (sim K1), simüle dik keratometri (sim K2), en yüksek keratometri (Kmax)] ve korneal astigmatizma (Cyl) değerleri karşılaştırıldı. BULGULAR: EİDGK postperatif 12. ayda artmakla birlikte muayeneler arasında istatistiksel anlamlı bir değişim gözlenmedi (p=0.052). MKK, EİKK açısından takip boyunca bulgular benzerdi istatistiksel anlamlı bir değişim mevcut değildi (p=0.806, p=0.063, sırasıyla). Sim K1, sim K2, Kmax ve Cyl değerlerinde sabitlenme olduğu ve preoperatif döneme kıyasla postopertif bir yıllık izlemde anlamlı bir değişim olmadığı görüldü (p=0.619, p=0.661, p=0.953, p=0.311, sırasıyla). TARTIŞMA ve SONUÇ: Transepitelyal crosslinking tedavisinin pediatrik yaş grubu progresif keratokonuslarında kolay uygulanabilir, konforlu ve progresyonu durdurabilir bir yöntem olduğu düşünüldü.

Effect of Transepithelial Crosslinking Treatment on Pediatric Keratoconus

INTRODUCTION: The aim of this study was to investigate the efficacy of transepithelial corneal collagen crosslinking (CXL) technique in patients with pediatric keratoconus. METHODS: 33 eyes of 18 patients who were admitted to Kocaeli University Faculty of Medicine, Department of Ophthalmology for the treatment of progressive keratoconus under the age of 18 years who were admitted in 2015-2016 years and followed up at least one year were retrospectively evaluated. The best corrected visual acuity (BCVA), central corneal thickness (CCT), thickness of thinnest location (TTL), keratometric values [simulated flat keratometry (K1), simulated step keratometry (K2), maximum corneal steepness (Kmax)] and corneal astigmatism (Cyl) values were assessed by Sirius topography preoperatively and in postoperative 1, 3, 6 and 12 months. RESULTS: There was no statistically significant difference between preoperative and postoperative examinations in terms of BCVA (p = 0.052). There was no statistically significant change in CCT and TTL findings during follow-up (p = 0.806, p = 0.063, respectively). It was seen that Sim K1, sim K2, Kmax and Cyl values were similar between preoperative and postoperative one year follow-up (p = 0.619, p = 0.661, p = 0.953, p = 0.311, respectively)DISCUSSION and CONCLUSION: Transepithelial crosslinking treatment was observed to be easy to apply, comfortable and prevent progression in pediatric age group of keratoconus.

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