American Academy of Ophthalmology Meeting

American Academy of Ophthalmology Meeting

November 21, 2013
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Cross-linking shows early, transient results in children

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NEW ORLEANS — Corneal cross-linking yielded early changes in children, but the changes were shorter lived than in adults, according to a study presented here.

“On one hand, cross-linking seems to be efficient in pediatric and adolescent patients, but we have to pay particular attention to year 3 of the long-term follow-up,” Farhad Hafezi, MD, PhD, said during the Journal of Refractive Surgery’s Hot, Hotter and Hottest: Late Breaking News session on Refractive Surgery Subspecialty Day preceding the American Academy of Ophthalmology meeting.

Cross-linking should be performed in children and adolescents without waiting for signs of progression, Hafezi said.

The retrospective cohort included 46 keratoconic eyes of children aged 8 years to 19 years who underwent corneal collagen cross-linking with riboflavin and ultraviolet-A irradiation. Mean follow-up was 26.3 months.

“What we found was quite interesting,” Hafezi said. “One one hand, looking at the arrest of progression and the flattening effect, children and adolescents behaved quite similarly to what we are used to seeing in adults. They react even a little faster. We sometimes see an arrest of progression or even a flattening effect at 3 months [in children] instead of 6 months in adults.”

Results showed a reduction of more than 1 D of flattening at 24 months. However, at 3 years, keratometry was stable and similar to baseline values.

Keratoconus progressed in 88% of eyes.

Disclosure: Hafezi has received grant support from Schwind and Ziemer Ophthalmics.