Outcomes of accelerated corneal cross-linking for pediatric and adult keratoconus: a comparative study
Purpose To compare the visual, refractive, and topographic outcomes of a high irradiance accelerated corneal crosslinking (ACXL) protocol after a 12-month follow-up between pediatric and adult patients with progressive keratoconus (KC). Methods Retrospective, comparative, cohort study. Patients with...
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| Veröffentlicht in: | International ophthalmology 2024-03, Vol.44 (1), p.145-145, Article 145 |
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| creator | Bustamante-Arias, Andres Hernandez-Camarena, Julio C. Rodriguez-Garcia, Alejandro Ruiz-Lozano, Raul E. Rodriguez-Gutierrez, Luis A. Valdez-Garcia, Jorge E. |
| description | Purpose
To compare the visual, refractive, and topographic outcomes of a high irradiance accelerated corneal crosslinking (ACXL) protocol after a 12-month follow-up between pediatric and adult patients with progressive keratoconus (KC).
Methods
Retrospective, comparative, cohort study. Patients with KC were divided into two groups: pediatric (≤ 18 years) and adult (> 18 years). All of them were managed with epi-OFF ACXL (30 mW/cm
2
, 8 min, pulsed 1:1 on and off = 7.2 J/cm
2
). Visual, refractive, and topographic values were measured preoperatively and at 1, 3, 6, and 12 months postoperative. KC progression, defined as a K
max
increase of ≥ 1D during follow-up, was recorded.
Results
Eighty-nine eyes (53 patients) were included for analysis; 45 (50.6%) eyes were from pediatric patients and 44 (49.4%) from adults. At one-year follow-up, pediatric patients experienced significantly higher rates of progression (22.2% vs. 4.5%,
p
= .014). Contrariwise, female gender (Beta = − 3.62,
p
= .018), a baseline uncorrected visual acuity of Snellen ≥ 20/60 (Beta = − 5.96,
p
= .007), and being ≥ 15 years at ACXL treatment (Beta = − 0.31,
p
= .021) were associated with non-progressive disease. A significant improvement in best-corrected visual acuity, K
min
, K
m
, and K
max
was recorded in both groups. Overall, 86.5% of eyes from both groups showed K
max
stabilization or improvement.
Conclusions
Despite the similarity in visual, refractive, and topographic outcomes in both groups, younger age was associated with KC progression after ACXL at one year of follow-up. |
| doi_str_mv | 10.1007/s10792-024-03080-2 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2968922286</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2968922286</sourcerecordid><originalsourceid>FETCH-LOGICAL-c326t-ef0e92bac45406df3a64148f9ceb7837d034a89a3825739f3d0a4af383f685663</originalsourceid><addsrcrecordid>eNp9kctOHDEQRa0IFB7JD2QRWWKTTYfyY9x2dgglgIQ0G1hbNX6ghu72xO5Gmr_HM0MSxCIrl1znXrvqEvKFwXcG0J4XBq3hDXDZgAANDf9AjtmiFQ1XAg7e1EfkpJRHADCtUR_JkdDSaM7MMYnLeXJpCIWmSNG50IeMU_DUpTwG7KnLqZSm78anbnygMWW6Dr7DKXeO4ugp-rmf6NNWlVwa5_KDYhUPa6w33XOgZZr95hM5jNiX8Pn1PCX3v37eXV43t8urm8uL28YJrqYmRAiGr9DJhQTlo0AlmdTRuLBqtWg9CInaoNC8jmai8IASo9AiKr1QSpySb3vfdU6_51AmO3SlDtXjGNJcLDdKG8653qJn79DHNOex_m5LCWALwWSl-J7a7SGHaNe5GzBvLAO7TcHuU7A1BbtLwfIq-vpqPa-G4P9K_qy9AmIPlNoaH0L-9_Z_bF8AIVaSnQ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2963015314</pqid></control><display><type>article</type><title>Outcomes of accelerated corneal cross-linking for pediatric and adult keratoconus: a comparative study</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Bustamante-Arias, Andres ; Hernandez-Camarena, Julio C. ; Rodriguez-Garcia, Alejandro ; Ruiz-Lozano, Raul E. ; Rodriguez-Gutierrez, Luis A. ; Valdez-Garcia, Jorge E.</creator><creatorcontrib>Bustamante-Arias, Andres ; Hernandez-Camarena, Julio C. ; Rodriguez-Garcia, Alejandro ; Ruiz-Lozano, Raul E. ; Rodriguez-Gutierrez, Luis A. ; Valdez-Garcia, Jorge E.</creatorcontrib><description>Purpose
To compare the visual, refractive, and topographic outcomes of a high irradiance accelerated corneal crosslinking (ACXL) protocol after a 12-month follow-up between pediatric and adult patients with progressive keratoconus (KC).
Methods
Retrospective, comparative, cohort study. Patients with KC were divided into two groups: pediatric (≤ 18 years) and adult (> 18 years). All of them were managed with epi-OFF ACXL (30 mW/cm
2
, 8 min, pulsed 1:1 on and off = 7.2 J/cm
2
). Visual, refractive, and topographic values were measured preoperatively and at 1, 3, 6, and 12 months postoperative. KC progression, defined as a K
max
increase of ≥ 1D during follow-up, was recorded.
Results
Eighty-nine eyes (53 patients) were included for analysis; 45 (50.6%) eyes were from pediatric patients and 44 (49.4%) from adults. At one-year follow-up, pediatric patients experienced significantly higher rates of progression (22.2% vs. 4.5%,
p
= .014). Contrariwise, female gender (Beta = − 3.62,
p
= .018), a baseline uncorrected visual acuity of Snellen ≥ 20/60 (Beta = − 5.96,
p
= .007), and being ≥ 15 years at ACXL treatment (Beta = − 0.31,
p
= .021) were associated with non-progressive disease. A significant improvement in best-corrected visual acuity, K
min
, K
m
, and K
max
was recorded in both groups. Overall, 86.5% of eyes from both groups showed K
max
stabilization or improvement.
Conclusions
Despite the similarity in visual, refractive, and topographic outcomes in both groups, younger age was associated with KC progression after ACXL at one year of follow-up.</description><identifier>ISSN: 1573-2630</identifier><identifier>ISSN: 0165-5701</identifier><identifier>EISSN: 1573-2630</identifier><identifier>DOI: 10.1007/s10792-024-03080-2</identifier><identifier>PMID: 38498219</identifier><language>eng</language><publisher>Dordrecht: Springer Netherlands</publisher><subject>Acuity ; Adult ; Child ; Cohort Studies ; Collagen - therapeutic use ; Comparative studies ; Cornea ; Corneal Cross-Linking ; Corneal Topography - methods ; Cross-Linking Reagents - therapeutic use ; Crosslinking ; Eye ; Female ; Follow-Up Studies ; Humans ; Irradiance ; Keratoconus ; Keratoconus - diagnosis ; Keratoconus - drug therapy ; Medicine ; Medicine & Public Health ; Ophthalmology ; Original Paper ; Patients ; Pediatrics ; Photochemotherapy - methods ; Photosensitizing Agents - therapeutic use ; Retrospective Studies ; Riboflavin - therapeutic use ; Topography ; Ultraviolet Rays ; Visual acuity</subject><ispartof>International ophthalmology, 2024-03, Vol.44 (1), p.145-145, Article 145</ispartof><rights>The Author(s), under exclusive licence to Springer Nature B.V. 2024. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2024. The Author(s), under exclusive licence to Springer Nature B.V.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c326t-ef0e92bac45406df3a64148f9ceb7837d034a89a3825739f3d0a4af383f685663</cites><orcidid>0000-0002-1790-8344 ; 0000-0001-7022-2395 ; 0000-0003-2455-3403 ; 0000-0001-8828-720X ; 0000-0002-1419-2109</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10792-024-03080-2$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10792-024-03080-2$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38498219$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bustamante-Arias, Andres</creatorcontrib><creatorcontrib>Hernandez-Camarena, Julio C.</creatorcontrib><creatorcontrib>Rodriguez-Garcia, Alejandro</creatorcontrib><creatorcontrib>Ruiz-Lozano, Raul E.</creatorcontrib><creatorcontrib>Rodriguez-Gutierrez, Luis A.</creatorcontrib><creatorcontrib>Valdez-Garcia, Jorge E.</creatorcontrib><title>Outcomes of accelerated corneal cross-linking for pediatric and adult keratoconus: a comparative study</title><title>International ophthalmology</title><addtitle>Int Ophthalmol</addtitle><addtitle>Int Ophthalmol</addtitle><description>Purpose
To compare the visual, refractive, and topographic outcomes of a high irradiance accelerated corneal crosslinking (ACXL) protocol after a 12-month follow-up between pediatric and adult patients with progressive keratoconus (KC).
Methods
Retrospective, comparative, cohort study. Patients with KC were divided into two groups: pediatric (≤ 18 years) and adult (> 18 years). All of them were managed with epi-OFF ACXL (30 mW/cm
2
, 8 min, pulsed 1:1 on and off = 7.2 J/cm
2
). Visual, refractive, and topographic values were measured preoperatively and at 1, 3, 6, and 12 months postoperative. KC progression, defined as a K
max
increase of ≥ 1D during follow-up, was recorded.
Results
Eighty-nine eyes (53 patients) were included for analysis; 45 (50.6%) eyes were from pediatric patients and 44 (49.4%) from adults. At one-year follow-up, pediatric patients experienced significantly higher rates of progression (22.2% vs. 4.5%,
p
= .014). Contrariwise, female gender (Beta = − 3.62,
p
= .018), a baseline uncorrected visual acuity of Snellen ≥ 20/60 (Beta = − 5.96,
p
= .007), and being ≥ 15 years at ACXL treatment (Beta = − 0.31,
p
= .021) were associated with non-progressive disease. A significant improvement in best-corrected visual acuity, K
min
, K
m
, and K
max
was recorded in both groups. Overall, 86.5% of eyes from both groups showed K
max
stabilization or improvement.
Conclusions
Despite the similarity in visual, refractive, and topographic outcomes in both groups, younger age was associated with KC progression after ACXL at one year of follow-up.</description><subject>Acuity</subject><subject>Adult</subject><subject>Child</subject><subject>Cohort Studies</subject><subject>Collagen - therapeutic use</subject><subject>Comparative studies</subject><subject>Cornea</subject><subject>Corneal Cross-Linking</subject><subject>Corneal Topography - methods</subject><subject>Cross-Linking Reagents - therapeutic use</subject><subject>Crosslinking</subject><subject>Eye</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Irradiance</subject><subject>Keratoconus</subject><subject>Keratoconus - diagnosis</subject><subject>Keratoconus - drug therapy</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Ophthalmology</subject><subject>Original Paper</subject><subject>Patients</subject><subject>Pediatrics</subject><subject>Photochemotherapy - methods</subject><subject>Photosensitizing Agents - therapeutic use</subject><subject>Retrospective Studies</subject><subject>Riboflavin - therapeutic use</subject><subject>Topography</subject><subject>Ultraviolet Rays</subject><subject>Visual acuity</subject><issn>1573-2630</issn><issn>0165-5701</issn><issn>1573-2630</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kctOHDEQRa0IFB7JD2QRWWKTTYfyY9x2dgglgIQ0G1hbNX6ghu72xO5Gmr_HM0MSxCIrl1znXrvqEvKFwXcG0J4XBq3hDXDZgAANDf9AjtmiFQ1XAg7e1EfkpJRHADCtUR_JkdDSaM7MMYnLeXJpCIWmSNG50IeMU_DUpTwG7KnLqZSm78anbnygMWW6Dr7DKXeO4ugp-rmf6NNWlVwa5_KDYhUPa6w33XOgZZr95hM5jNiX8Pn1PCX3v37eXV43t8urm8uL28YJrqYmRAiGr9DJhQTlo0AlmdTRuLBqtWg9CInaoNC8jmai8IASo9AiKr1QSpySb3vfdU6_51AmO3SlDtXjGNJcLDdKG8653qJn79DHNOex_m5LCWALwWSl-J7a7SGHaNe5GzBvLAO7TcHuU7A1BbtLwfIq-vpqPa-G4P9K_qy9AmIPlNoaH0L-9_Z_bF8AIVaSnQ</recordid><startdate>20240318</startdate><enddate>20240318</enddate><creator>Bustamante-Arias, Andres</creator><creator>Hernandez-Camarena, Julio C.</creator><creator>Rodriguez-Garcia, Alejandro</creator><creator>Ruiz-Lozano, Raul E.</creator><creator>Rodriguez-Gutierrez, Luis A.</creator><creator>Valdez-Garcia, Jorge E.</creator><general>Springer Netherlands</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QL</scope><scope>7T7</scope><scope>7TK</scope><scope>7U9</scope><scope>8FD</scope><scope>C1K</scope><scope>FR3</scope><scope>H94</scope><scope>K9.</scope><scope>M7N</scope><scope>P64</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-1790-8344</orcidid><orcidid>https://orcid.org/0000-0001-7022-2395</orcidid><orcidid>https://orcid.org/0000-0003-2455-3403</orcidid><orcidid>https://orcid.org/0000-0001-8828-720X</orcidid><orcidid>https://orcid.org/0000-0002-1419-2109</orcidid></search><sort><creationdate>20240318</creationdate><title>Outcomes of accelerated corneal cross-linking for pediatric and adult keratoconus: a comparative study</title><author>Bustamante-Arias, Andres ; Hernandez-Camarena, Julio C. ; Rodriguez-Garcia, Alejandro ; Ruiz-Lozano, Raul E. ; Rodriguez-Gutierrez, Luis A. ; Valdez-Garcia, Jorge E.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c326t-ef0e92bac45406df3a64148f9ceb7837d034a89a3825739f3d0a4af383f685663</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Acuity</topic><topic>Adult</topic><topic>Child</topic><topic>Cohort Studies</topic><topic>Collagen - therapeutic use</topic><topic>Comparative studies</topic><topic>Cornea</topic><topic>Corneal Cross-Linking</topic><topic>Corneal Topography - methods</topic><topic>Cross-Linking Reagents - therapeutic use</topic><topic>Crosslinking</topic><topic>Eye</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Irradiance</topic><topic>Keratoconus</topic><topic>Keratoconus - diagnosis</topic><topic>Keratoconus - drug therapy</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Ophthalmology</topic><topic>Original Paper</topic><topic>Patients</topic><topic>Pediatrics</topic><topic>Photochemotherapy - methods</topic><topic>Photosensitizing Agents - therapeutic use</topic><topic>Retrospective Studies</topic><topic>Riboflavin - therapeutic use</topic><topic>Topography</topic><topic>Ultraviolet Rays</topic><topic>Visual acuity</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bustamante-Arias, Andres</creatorcontrib><creatorcontrib>Hernandez-Camarena, Julio C.</creatorcontrib><creatorcontrib>Rodriguez-Garcia, Alejandro</creatorcontrib><creatorcontrib>Ruiz-Lozano, Raul E.</creatorcontrib><creatorcontrib>Rodriguez-Gutierrez, Luis A.</creatorcontrib><creatorcontrib>Valdez-Garcia, Jorge E.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Industrial and Applied Microbiology Abstracts (Microbiology A)</collection><collection>Neurosciences Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Technology Research Database</collection><collection>Environmental Sciences and Pollution Management</collection><collection>Engineering Research Database</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>International ophthalmology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bustamante-Arias, Andres</au><au>Hernandez-Camarena, Julio C.</au><au>Rodriguez-Garcia, Alejandro</au><au>Ruiz-Lozano, Raul E.</au><au>Rodriguez-Gutierrez, Luis A.</au><au>Valdez-Garcia, Jorge E.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Outcomes of accelerated corneal cross-linking for pediatric and adult keratoconus: a comparative study</atitle><jtitle>International ophthalmology</jtitle><stitle>Int Ophthalmol</stitle><addtitle>Int Ophthalmol</addtitle><date>2024-03-18</date><risdate>2024</risdate><volume>44</volume><issue>1</issue><spage>145</spage><epage>145</epage><pages>145-145</pages><artnum>145</artnum><issn>1573-2630</issn><issn>0165-5701</issn><eissn>1573-2630</eissn><abstract>Purpose
To compare the visual, refractive, and topographic outcomes of a high irradiance accelerated corneal crosslinking (ACXL) protocol after a 12-month follow-up between pediatric and adult patients with progressive keratoconus (KC).
Methods
Retrospective, comparative, cohort study. Patients with KC were divided into two groups: pediatric (≤ 18 years) and adult (> 18 years). All of them were managed with epi-OFF ACXL (30 mW/cm
2
, 8 min, pulsed 1:1 on and off = 7.2 J/cm
2
). Visual, refractive, and topographic values were measured preoperatively and at 1, 3, 6, and 12 months postoperative. KC progression, defined as a K
max
increase of ≥ 1D during follow-up, was recorded.
Results
Eighty-nine eyes (53 patients) were included for analysis; 45 (50.6%) eyes were from pediatric patients and 44 (49.4%) from adults. At one-year follow-up, pediatric patients experienced significantly higher rates of progression (22.2% vs. 4.5%,
p
= .014). Contrariwise, female gender (Beta = − 3.62,
p
= .018), a baseline uncorrected visual acuity of Snellen ≥ 20/60 (Beta = − 5.96,
p
= .007), and being ≥ 15 years at ACXL treatment (Beta = − 0.31,
p
= .021) were associated with non-progressive disease. A significant improvement in best-corrected visual acuity, K
min
, K
m
, and K
max
was recorded in both groups. Overall, 86.5% of eyes from both groups showed K
max
stabilization or improvement.
Conclusions
Despite the similarity in visual, refractive, and topographic outcomes in both groups, younger age was associated with KC progression after ACXL at one year of follow-up.</abstract><cop>Dordrecht</cop><pub>Springer Netherlands</pub><pmid>38498219</pmid><doi>10.1007/s10792-024-03080-2</doi><tpages>1</tpages><orcidid>https://orcid.org/0000-0002-1790-8344</orcidid><orcidid>https://orcid.org/0000-0001-7022-2395</orcidid><orcidid>https://orcid.org/0000-0003-2455-3403</orcidid><orcidid>https://orcid.org/0000-0001-8828-720X</orcidid><orcidid>https://orcid.org/0000-0002-1419-2109</orcidid></addata></record> |
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| ispartof | International ophthalmology, 2024-03, Vol.44 (1), p.145-145, Article 145 |
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| source | MEDLINE; SpringerLink Journals - AutoHoldings |
| subjects | Acuity Adult Child Cohort Studies Collagen - therapeutic use Comparative studies Cornea Corneal Cross-Linking Corneal Topography - methods Cross-Linking Reagents - therapeutic use Crosslinking Eye Female Follow-Up Studies Humans Irradiance Keratoconus Keratoconus - diagnosis Keratoconus - drug therapy Medicine Medicine & Public Health Ophthalmology Original Paper Patients Pediatrics Photochemotherapy - methods Photosensitizing Agents - therapeutic use Retrospective Studies Riboflavin - therapeutic use Topography Ultraviolet Rays Visual acuity |
| title | Outcomes of accelerated corneal cross-linking for pediatric and adult keratoconus: a comparative study |
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