Results of Follow-up in Pediatric Keratoconus Treated With Intracorneal Ring Segments Implantation Alone or in Combination With Corneal Cross-linking.

Published on Sep 1, 2021in Journal of Pediatric Ophthalmology & Strabismus1.402
· DOI :10.3928/01913913-20210719-02
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Abstract
PURPOSE To report visual and topographic outcomes of pediatric keratoconus with intracorneal ring segments (ICRS) implantation alone or in combination with accelerated corneal cross-linking (A-CXL). METHODS A descriptive, retrospective observational study was performed. Medical records of patients younger than 18 years at Fundacion Oftalmologica Nacional in Bogota, Colombia, were reviewed. Demographic data, follow-up time, preoperative and postoperative uncorrected (UCVA) and best corrected (BCVA) visual acuity, manifest refraction, and tomography were evaluated. SPSS software (version 22.0; SPSS, Inc) was used for analysis. RESULTS Twenty-six eyes of 19 patients with a mean age of 16.5 ± 1.8 years were analyzed, and 16 were boys (84.2%). Median follow-up time was 39.6 months (interquartile range [IQR] = 30). Fifteen patients (78.9%) had a history of allergic conjunctivitis. Sixteen eyes (61.5%) received ICRS implantation with A-CXL and 10 eyes (38.4%) received ICRS implantation only. Global results (including ICRS implantation with A-CXL and ICRS implantation only) were: (1) median UCVA of 0.90 logarithm of the minimum angle of resolution (logMAR) (IQR = 0.85) preoperatively improved to 0.54 logMAR (IQR = 0.70) postoperatively; (2) median BCVA of 0.43 logMAR (IQR = 0.39) preoperatively improved to 0.30 logMAR (IQR = 0.26) postoperatively; and (3) median spherical equivalent of -5.37 diopters (D) (IQR = -5.28) preoperatively improved to -4.12 D (IQR = -3.57) postoperatively. There was a reduction in half of the sphere and cylinder. The median maximum keratometry was 54.40 D (IQR = 7.4) preoperatively and 49.80 D (IQR = 5.3) postoperatively. The median asphericity was -1.18 (IQR = 0.70) preoperatively and changed to -0.75 (IQR = 0.68) postoperatively. No patient presented with complications before or after surgery. CONCLUSIONS ICRS implantation only or in combination with A-CXL induced visual and topographic improvement in patients with keratoconus, which was maintained throughout the follow-up time. It seems to be a safe procedure to delay or avoid corneal transplantation in the pediatric population. [J Pediatr Ophthalmol Strabismus. 20XX;XX(X):XX-XX.].
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#2Samira Heydarian (Mazandaran University of Medical Sciences)H-Index: 6
Last. Mehdi Khabazkhoob (Shahid Beheshti University of Medical Sciences and Health Services)H-Index: 32
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Purpose:This study was conducted to determine the prevalence and risk factors for keratoconus worldwide.Methods:In this meta-analysis, using a structured search strategy from 2 sources, 4 electronic databases (PubMed, Web of Science, Google Scholar, and Scopus) and the reference lists of the selecte
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#1Sabrina Mukhtar (VCU: Virginia Commonwealth University)H-Index: 2
#2Balamurali K. Ambati (UofU: University of Utah)H-Index: 37
Purpose To describe the epidemiology and prevalence, rates of progression, difference between adult and pediatric populations, and therapeutic approaches to pediatric keratoconus from documented literature.
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#2José F. AlfonsoH-Index: 35
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PURPOSE: To compare the predictability of intrastromal tunnel depth creation for intrastromal corneal ring segments (ICRS) implantation between manual dissection and femtosecond laser using a high-resolution anterior segment optical coherence tomography (AS-OCT). METHODS: This multicenter study included patients with keratoconus who had Ferrara-type ICRS implantation at Hospital de Braga using manual dissection and at the Fernandez-Vega Ophthalmological Institute using the femtosecond laser tech...
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#1A AbreuH-Index: 2
#2Luísa MalheiroH-Index: 3
Last. Pedro MenéresH-Index: 3
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Purpose: To analyze the long-term outcomes of intracorneal ring segments (ICRS) implantation for keratoconus management in pediatric patients. Methods: Retrospective case series review of the long-term (>5 years) outcomes of Intacs® ICRS implantation for keratoconus in pediatric patients (age <18 years old at the time of surgery) between January 2008 and December 2011 at Ophthalmology Department of Hospital de Santo Antonio. Demographic data, follow-up time, preoperative and postoperative uncorr...
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#1Karolína Kapitánová (Comenius University in Bratislava)H-Index: 4
#2Jaroslav NikelH-Index: 1
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Last. Mahgol Farjadnia (IUMS: Iran University of Medical Sciences)H-Index: 5
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Purpose To compare the ophthalmic parameters and the severity of keratoconus (KC) in pediatrics and adults at the time of initial diagnosis in an Iranian population.
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#1Youssef Abdelmassih (""St. Joe's"": Saint Joseph's University)H-Index: 9
#2Sylvain El-Khoury (""St. Joe's"": Saint Joseph's University)H-Index: 6
Last. Elias JaradeH-Index: 13
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Purpose To evaluate the safety and visual outcome of intracorneal ring segment (ICRS) implantation followed by cross-linking in pediatric keratoconus patients. Design Retrospective interventional case series. Methods This retrospective study included pediatric patients (aged ≤14 years) with keratoconus and poor corrected distance visual acuity (CDVA) that underwent ICRS implantation and cross-linking (CXL). ICRS were inserted under topical anesthesia after creating a corneal tunnel with a femtos...
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#2Frank Doyle (RCSI: Royal College of Surgeons in Ireland)H-Index: 28
Last. Michael O'Keefe (TU: Temple University)H-Index: 6
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Keratoconus can behave more aggressively in pediatric than in adult patients. We systematically reviewed the literature to determine the effectiveness of corneal collagen cross-linking (CXL) in children. For this study, MEDLINE® and Cochrane databases were searched for all studies examining the effects of standard, trans-epithelial or accelerated CXL protocols in patients age 18 years or younger. Primary outcomes were; uncorrected visual acuity (UCVA) and maximum keratometry (Kmax) and secondary...
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#2Alejandro TelloH-Index: 13
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