Corneal cross-linking may slow keratoconus in pediatric patients
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WASHINGTON — Corneal cross-linking is an option to slow keratoconus progression in pediatric patients, according to a speaker here.
“Keratoconus is a big deal in children. It has been diagnosed in kids as young as 4 years old, although most of the time it is diagnosed in the teenage years,” Maria S. Cortina, MD, ABO, said at the American Society of Cataract and Refractive Surgery meeting. “It remains the most common indication for keratoplasty in this age group, and we know that young age is an independent risk factor for progression.”
Cross-linking should be performed in pediatric patients with progressive disease only, Cortina said, and spontaneous stabilization may be higher than previously thought. Early screening followed by cross-linking can potentially preserve vision and decrease the need for contact lenses and keratoplasty.
“If we look at the long-term studies, we see that progression after cross-linking can be up to 24%,” Cortina said. “This suggests that corneas in children do react to cross-linking effectively, but the effect may not be long term for everybody.”
More studies are needed to better define keratoconus progression following cross-linking as well as appropriate re-treatment protocols, she said.
“Early screening and early treatment have the potential to really change the disease course,” Cortina said.
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Cortina MS. Is it too early to crosslink in the pediatric population for keratoconus? Presented at: American Society of Cataract and Refractive Surgery meeting; April 22-26, 2022; Washington.
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