First Author: MicheleFortunato ITALY
Co Author(s): Angela Turtoro
Purpose:
To evaluate the clinical effects of corneal Cross-Linking with and without de-epithelialization on paediatric keratoconic eyes.
Setting:
: Bambino Gesu Hospital Rome
Methods:
Authors performed UV corneal Cross-Linking in 20 paediatric eyes (age: 9-16 years) with severe keratoconus : 16 eyes were treated with epithelial alcoholic removing (first group) and 4 eyes with trans-epithelial Cross-Linking (second group, with corneal thickness < 400 mm). In all eyes Riboflavin 0.1% was instilled for 30 minutes, ultraviolet A irradiation was applied for 30 minutes, while riboflavin was instilled every 5 minutes. The follow-up time was 2 years for the first group and 6 months for second group.
Results:
Progression of keratectasia was stopped in all patients; Best corrected visual acuity and the maximal keratometry values improved in all cases. Corneal transparency, the degree of keratectasia registered by corneal topography and the density of endothelial cells remained unchanged and stable within the follow-up time. In first group Authors observed in 1 eye a delayed re-epithelialization, treated and resolved with topical medications and application of contact lens. In second group no complications were observed within the follow-up time.
Conclusions:
in paediatric age has a different and dramatically quick progression than in adult eyes, despite the high elasticity of young corneas; therefore, a minimally invasive therapy that delays and doesnt preclude transplantation at a later stage is precious. Authors believe that trans-epithelial Cross-Linking could be applied to every kind of paediatric keratoconus because it is easier to perform to increate cooperation of young patients and no complications of re-epithalization FINANCIAL INTEREST: NONE