Результаты лечения кератоэктазий методом кросслинкинга роговицы у детей и подростков

[摘要] Purpose.The aim is to assess the results and features of keratectasia treatment in children and teenagers by the method of corneal collagen cross-linking. Material and methods.The study included 14 children (17 eyes) with keratectasia aged from 11 to 18 years, who underwent corneal cross-linking surgery using the UFalink device with a photo-sensitizer according to the standard Dresden protocol. The diagnosis of keratoconus was detected in 14 eyes, marginal degeneration of cornea – in 3 eyes, among them the stage I of disease occurred in 2 patients (2 eyes ), the stage II – in 12 cases (12 eyes). The examination of patients used the following ophthalmic research methods: visometry, bio-microscopy, ophthalmoscopy, autorefractometry, tonometry, keratometry, corneal topography, pachymetry, confocal microscopy. Results.There were no complications intra-operatively as well as in early and late postoperative periods. A pseudo-haze of various severity degree was observed in all patients, starting from the first week. In the confocal microscopy, many of hyperreflexogenic keratocytes and phenomena of apoptosis in the corneal area, exposed to UV-irradiation at a depth of 280±40μm, polymorphic hyper-reflecting structures were noted on the second day after the cross-linking procedure. The refractive power of the cornea decreased on an average by 1.14±2.13D, the thickness of the cornea in the center - by 28.04±0.14μm 6 months after surgery. Corneal astigmatism decreased on an average by 1.55±1.4D 24 months after the cross-linking procedure. The uncorrected visual acuity (UCVA) of patients 6 months after the surgery increased on an average up to 0.45±0.16 (preoperatively 0.32±0.14) and 24 months later – up to 0.5±0.14. The best corrected visual acuity (BCVA) improved as well, 6 months later and was 0.6±0.12 (preoperatively 0.5±0.16), 24 months later – 0.7±0.14. Conclusions.The cross-linking of corneal collagen is a safe and effective treatment method for progressive forms of keratectasia in children and teenagers and contributes to the stabilization of the disease.

[学科分类] 眼科学

[关键词] keratectasia (keratoconus);children and teenagers;cross-linking.;кератоэктазии;дети и подростки;кросслинкинг.