Accelerated corneal crosslinking-induced corneal topographic and endothelial changes in paediatric patients with progressive keratoconus: 6-month follow-up

Abstract

Introduction The aim of the accelerated corneal cross-linking (A-CXL) procedure is to halt the progression of keratoconus. Nonetheless, there is only a paucity of data reporting post-operative A-CXLinduced corneal topographic and endothelial changes in children. Our aim was to assess the 6-month changes in corneal topographic and endothelial values after A-CXL in paediatric patients with progressive keratoconus (PKC). Methods and MaterialIn this retrospective study 11 eyes of 7 paediatric patients with PKC, who received A-CXL from 2019 to 2022 at the Hospital of Lithuanian University of Health Sciences Kaunas Clinics, Department of Ophthalmology (Kaunas, Lithuania), were enrolled. Uncorrected visualacuity (UCVA), best corrected visual acuity (BCVA), intraocular pressure (IOP), parameters of corneal topography (Kmax, Kflat, Ksteep), thinnest corneal thickness (TCT) and endothelium (cell dencity (CD), coefficient of variation (CV), number of hexagonal cells (HEX) were evaluated at the baseline and 1, 3, 6 months after A-CXL. The statistic alanalysis was performed using IBM SPSS v. 25.0 software. Results There was a significant decrease of the mean UCVA (0,72±0,55logMAR) and an increase of IOP (14±5 mmHg) values atthe first postoperative month (PM) in relation to baseline results (0,48±0,48logMAR [p=0,007] and 11 ± 3 mmHg [p=0,016], respectively).The mean Kmax values were significantly lower only at 3PM (57,1±7,9D [p=0,021]) and 6PM (56,0±7,9D [p=0,005]) in respect of baseline results (58,2±7,9D). There was a significant decrease of the mean Ksteep at 6PM (48,8±4,3D) and an increase of Kflat (46,4±3,9D) values at 1PM in relation to baseline results (50,0±4,4D [p=0,004] and 45,9±3,7D [p=0,036], respectively). TCT was significantly lower at 3PM (455 ±44μm [p=0,009]) and 6PM (449±48μm [p=0,008]) in comparison with the preoperative data (474±41μm). Study results showed a significant decrease of the mean HEX at 1PM (61±7% [p=0,018]), 3PM (63±7% [p=0,050]) and 6PM (61±6% [p=0,050]), as well as an increase of CV values at 3PM (29±9 [p=0,017]) and 6 PM (31±9 [p=0,017]) in relation to baseline results (68±5%and 25±5, respectively).We found no statistically significant changes in the mean BCVA and endothelial CD values after A-CXL. Conclusion A-CXL induces variable corneal topographic and endothelial changes in paediatric patients with PKC 6 months after the procedure.