Posters

Results of surgical treatment of keratoconus in patients with concomitant Down's syndrome

Poster Details

First Author: M. Bikbov RUSSIAN FEDERATION

Co Author(s):    E. Usubov   K. Oganisyan   N. Zaynullina   G. Bikbova           

Abstract Details

Purpose:

To evaluate the results of surgical treatment of different stages of keratoconus in patients with Down’s syndrome.

Setting:

Ufa Eye Research Institute, Ufa, Russia

Methods:

11 patients (22 eyes) with Down’s syndrome underwent the study. Subclinical stage - in 6 (27.3%), 1-2 stage - in 6 (27.3%), 3-4 stage - in 5 (22.7%), acute keratoconus - in 5 (18.2%) cases. The following methods of treatment were used: CXL in 4 patients with 1-2 stage of disease (18.2%); implantation of «Myoring» - in 22.7% of cases: in 5 eyes - epikeratoplasty – in 22.7% of cases: in 4 eyes with acute keratoconus and 1 eye with the 4th stage - penetrating keratoplasty (9.1%). In 6 cases (27.3%) for subclinical form follow-up was conducted.

Results:

Patients with 1-2 stages of keratoconus in 6 months after crosslinking showed a decrease in Kave by 2.0-4.0 D and corneal thickness by 31.05±0.22 µm, with no s change during 36 months. Patients with II-III stage after «Myoring» implantation showed reduction by 4,0-16,0 D of spherical and 2.0-8.0 D of cylindrical components of refraction. After epikeratoplasty corneal thickness increased significantly, in 4 of 5 cases a clear graft retention was observed. In 1 case in the early postoperative period due to rejection the graft was removed. After penetrating keratoplasty a clear graft retention was observed in 1 of 2 cases.

Conclusions:

The incidence of keratoconus in patients with Down’s syndrome may reach higher level than in the general population (20.4%), while in 45.5% of cases (10 eyes) the advanced stage is occured. The effectiveness of conventional treatments for early stages of keratoconus is comparable to those of patients without burdened premorbid background while the results of radical surgical apporoach are lower. Early diagnosis and treatment will reduce the incidence of end-stage disease and improve the efficiency of keratoconus treatment in this group of patients.

Financial Disclosure:

NONE