Implante de segmentos Intraestromales y Crosslinking acelerado en el tratamiento del Queratocono pediátrico

Abstract

Purpose: To describe visual and topographic outcomes of pediatric Keratoconus (KC) treatment with Intracorneal Ring Segment Implantation (ICRS) and accelerated Crosslinking (CXL). Methods: Descriptive observational study, were medical records of Fundonal patients in Bogotá, Colombia were reviewed. Children under 18 years with a history of KC who underwent ICRS alone or in combination with accelerated CXL were included. Demographic data, visual acuity, spherical equivalent, and corneal topography were evaluated. A descriptive analysis was performed with SPSS 22.0. Results: Twenty-six eyes of 17 patients with a mean age of 16.5 years (SD 1.8 years) were analyzed, 22 subjects (84.6%) were men. The median follow-up was 39.6 months (IQR 30 months). Twenty-one individuals (80%) had a history of allergic conjunctivitis. Sixteen eyes (61.5%) received ICRS with accelerated CXL. A clinically significant gain in visual acuity was found, with a preoperative median BCVA of 0.43 LogMAR (IQR 0.39) to a median BCVA in the last follow-up of 0.30 LogMAR (IQR 0.26). For the spherical equivalent, the preoperative median was -5.37 diopters (D) (IQR -5.28 D), improving postoperatively to -4.12 D (IQR -3.57 D). For topographic findings, the preoperative K2 median was 54.4 D (IQR 7.4 D) and postoperative it was 49.8 D (IQR 5.3 D). The topographic changes manifest flattening and centering of the cone. The main cone patterns were the round and the symmetrical bowtie. Conclusions: ICRS alone or in combination with accelerated CXL, induce visual and topographic improvement in pediatric KC, these findings were maintained during the follow-up time.