New progress in the pathogenesis of keratoconus in children and the indications and treatment of corneal collagen cross-linking surgery

doi:10.3877/cma.j.issn.2095-2007.2023.01.010

Abstract

Abstract:

Corneal keratoconus is a progressive dilated keratopathy that often occurs during adolescence, characterized by corneal dilation and thinning, as well as irregular astigmatism. Currently, corneal collagen cross-linking has become the main method for treating advanced keratoconus. Compared with adults with keratoconus, pediatric keratoconus have shown a faster progress and worse condition, which should be detected and treated as soon as possible. The epidemiology and pathogenesis of keratoconus in children, as well as new findings and developments in the indications, different surgical methods, surgical efficacy, and postoperative follow-up of corneal collagen cross-linking surgery (CXL) in children were reviewed in this paper.

Key words: Corneal collagen cross-linking, Keratoconus, Pediatric, Intracorneal ring segment implantation

Leran Chen, Yifei Yuan, Yueguo Chen. New progress in the pathogenesis of keratoconus in children and the indications and treatment of corneal collagen cross-linking surgery[J]. Chinese Journal of Ophthalmologic Medicine(Electronic Edition), 2023, 13(01): 50-54.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://zhykyxzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.2095-2007.2023.01.010

https://zhykyxzz.cma-cmc.com.cn/EN/Y2023/V13/I01/50

References 49

[1]	Torres Netto EA, Al－Otaibi WM, Hafezi NL, et al. Prevalence of keratoconus in paediatric patients in Riyadh, Saudi Arabia[J]. Br J Ophthalmol, 2018, 102(10): 1436－1441.
[2]	Hashemi H, Heydarian S, Hooshmand E, et al. The Prevalence and Risk Factors for Keratoconus: A Systematic Review and Meta－Analysis[J]. Cornea, 2020, 39(2): 263－270.
[3]	Spoerl E, Huhle M, Seiler T. Induction of cross－links in corneal tissue[J]. Exp Eye Res, 1998, 66(1): 97－103.
[4]	Kennedy RH, Bourne WM, Dyer JA. A 48－year clinical and epidemiologic study of keratoconus[J]. Am J Ophthalmol, 1986, 101(3): 267－273.
[5]	Sabti S, Tappeiner C, Frueh BE. Corneal Cross－Linking in a 4－Year－Old Child With Keratoconus and Down Syndrome[J]. Cornea, 2015, 34(9): 1157－1160.
[6]	El－Khoury S, Abdelmassih Y, Hamade A, et al. Pediatric Keratoconus in a Tertiary Referral Center: Incidence, Presentation, Risk Factors, and Treatment[J]. J Refract Surg, 2016, 32(8): 534－541.
[7]	Pearson AR, Soneji B, Sarvananthan N, et al. Does ethnic origin influence the incidence or severity of keratoconus？[J]. Eye (Lond), 2000, 14 (4): 625－628.
[8]	Loukovitis E, Sfakianakis K, Syrmakesi P, et al. Genetic Aspects of Keratoconus: A Literature Review Exploring Potential Genetic Contributions and Possible Genetic Relationships with Comorbidities[J]. Ophthalmol Ther, 2018, 7(2): 263－292.
[9]	Hardcastle AJ, Liskova P, Bykhovskaya Y, et al. A multi－ethnic genome－wide association study implicates collagen matrix integrity and cell differentiation pathways in keratoconus[J]. Commun Biol, 2021, 4(1): 266.
[10]	Gurnani B, Kaur K, Tripathy K. Is there a genetic link between Keratoconus and Fuch's endothelial corneal dystrophy？[J]. Med Hypotheses, 2021, 157: 110699.
[11]	Gordon－Shaag A, Millodot M, Shneor E, et al. The genetic and environmental factors for keratoconus[J]. Biomed Res Int, 2015: 795738.
[12]	Cristina Kenney M, Brown DJ. The cascade hypothesis of keratoconus[J]. Cont Lens Anterior Eye, 2003, 26(3): 139－146.
[13]	Balasubramanian SA, Mohan S, Pye DC, et al. Proteases, proteolysis and inflammatory molecules in the tears of people with keratoconus[J]. Acta Ophthalmol, 2012, 90(4): e303－309.
[14]	Balasubramanian SA, Pye DC, Willcox MD. Effects of eye rubbing on the levels of protease, protease activity and cytokines in tears: relevance in keratoconus[J]. Clin Exp Optom, 2013, 96(2): 214－218.
[15]	Olivo－Payne A, Abdala－Figuerola A, Hernandez－Bogantes E, et al. Optimal management of pediatric keratoconus: challenges and solutions[J]. Clinical Ophthalmology, 2019, 13: 1183－1191.
[16]	Léoni－Mesplié S, Mortemousque B, Touboul D, et al. Scalability and severity of keratoconus in children[J]. Am J Ophthalmol, 2012, 154(1): 56－62.
[17]	Chatzis N, Hafezi F. Progression of keratoconus and efficacy of pediatric[corrected]corneal collagen cross－linking in children and adolescents[J]. J Refract Surg, 2012, 28(11): 753－758.
[18]	Mukhtar S, Ambati BK. Pediatric keratoconus: a review of the literature[J]. International Ophthalmology, 2018, 38(5): 2257－2266.
[19]	Ertan A, Muftuoglu O. Keratoconus clinical findings according to different age and gender groups[J]. Cornea, 2008, 27(10): 1109－1113.
[20]	Anitha V, Vanathi M, Raghavan A, et al. Pediatric keratoconus － Current perspectives and clinical challenges[J]. Indian J Ophthalmol, 2021, 69(2): 214－225.
[21]	Mukhtar S, Ambati BK. Pediatric keratoconus: a review of the literature[J]. Int Ophthalmol, 2018, 38(5): 2257－2266.
[22]	El－Khoury S, Abdelmassih Y, Amro M, et al. The Effect of Age on Corneal Topographic Indices, Keratometry and Visual Acuity After Combined Intrastromal Corneal Ring Segment (ICRS) Implantation and Corneal Crosslinking[J]. Med Hypothesis Discov Innov Ophthalmol, 2020, 9(2): 135－142.
[23]	Barbisan PRT, Pinto RDP, Gusmo CC, et al. Corneal Collagen Cross－Linking in Young Patients for Progressive Keratoconus[J]. Cornea, 2020, 39(2): 186－191.
[24]	Soeters N, Van Der Valk R, Tahzib NG. Corneal cross－linking for treatment of progressive keratoconus in various age groups[J]. J Refract Surg, 2014, 30(7): 454－460.
[25]	Kobashi H, Rong SS, Ciolino JB. Transepithelial versus epithelium－off corneal crosslinking for corneal ectasia[J]. Journal of Cataract and Refractive Surgery, 2018, 44(12): 1507－1516.
[26]	Mazzotta C, Ferrise M, Gabriele G, et al. Chemically－Boosted Corneal Cross－Linking for the Treatment of Keratoconus through a Riboflavin 0.25% Optimized Solution with High Superoxide Anion Release[J]. J Clin Med, 2021, 10(6): 1324.
[27]	Fard AM, Reynolds AL, Lillvis JH, et al. Corneal collagen cross－linking in pediatric keratoconus with three protocols: a systematic review and meta－analysis[J]. J aapos, 2020, 24(6): 331－336.
[28]	Caporossi A, Mazzotta C, Paradiso AL, et al. Transepithelial corneal collagen crosslinking for progressive keratoconus: 24－month clinical results[J]. J Cataract Refract Surg, 2013, 39(8): 1157－1163.
[29]	Magli A, Vecchio EC, Carelli R, et al. Pediatric keratoconus and iontophoretic corneal crosslinking: refractive and topographic evidence in patients underwent general and topical anesthesia, 18 months of follow－up[J]. International Ophthalmology, 2016, 36(4): 585－590.
[30]	Zhang X, Zhao J, Li M, et al. Conventional and transepithelial corneal cross－linking for patients with keratoconus[J]. PLoS One, 2018, 13(4): e0195105.
[31]	Buzzonetti L, Petrocelli G, Valente P, et al. Iontophoretic Transepithelial Collagen Cross－Linking Versus Epithelium－Off Collagen Cross－Linking in Pediatric Patients: 3－Year Follow－Up[J]. Cornea, 2019, 38(7): 859－863.
[32]	Iqbal M, Elmassry A, Saad H, et al. Standard cross－linking protocol versus accelerated and transepithelial cross－linking protocols for treatment of paediatric keratoconus: a 2－year comparative study[J]. Acta Ophthalmologica, 2020, 98(3): e352－e362.
[33]	Eissa SA, Yassin A. Prospective, randomized contralateral eye study of accelerated and conventional corneal cross－linking in pediatric keratoconus[J]. International Ophthalmology, 2019, 39(5): 971－979.
[34]	Amer I, Elaskary A, Mostafa A, et al. Long－Term Visual, Refractive and Topographic Outcomes of " Epi－off" Corneal Collagen Cross－Linking in Pediatric Keratoconus: Standard versus Accelerated Protocol[J]. Clinical Ophthalmology, 2020, 14: 3747－3754.
[35]	Ozer MD, Batur M, Mesen S, et al. Comparison of the efficacy of accelerated corneal cross－linking therapy in different pediatric age groups having progressive keratoconus[J]. International Ophthalmology, 2020, 40(10): 2651－2658.
[36]	Park SE, Tseng M, Lee JK. Effectiveness of intracorneal ring segments for keratoconus[J]. Curr Opin Ophthalmol, 2019, 30(4): 220－228.
[37]	Singal N, Ong Tone S, Stein R, et al. Comparison of accelerated CXL alone, accelerated CXL－ICRS, and accelerated CXL－TG－PRK in progressive keratoconus and other corneal ectasias[J]. J Cataract Refract Surg, 2020, 46(2): 276－286.
[38]	Abreu AC, Malheiro L, Coelho J, et al. Implantation of intracorneal ring segments in pediatric patients: long－term follow－up[J]. International Medical Case Reports Journal, 2018, 11: 23－27.
[39]	Abozaid MA, Hassan Aa－A, Abdalla A. Intrastromal Corneal Ring Segments Implantation And Corneal Cross－Linking For Keratoconus In Children With Vernal Keratoconjunctivitis － Three－Year Results[J]. Clinical Ophthalmology, 2019, 13: 2151－2157.
[40]	Iqbal M, Elmassry A, Tawfik A, et al. Analysis of the Outcomes of Combined Cross－Linking with Intracorneal Ring Segment Implantation for the Treatment of Pediatric Keratoconus[J]. Current Eye Research, 2019, 44(2): 125－134.
[41]	Uakhan ö，Celik Buyuktepe T, Yavuz Z, et al. Pediatric versus Adult Corneal Collagen Crosslinking: Long－term Visual, Refractive, Tomographic and Aberrometric Outcomes[J]. Curr Eye Res, 2021, 46(1): 14－22.
[42]	Chan C. Corneal Cross－Linking for Keratoconus: Current Knowledge and Practice and Future Trends[J]. Asia Pac J Ophthalmol (Phila), 2020, 9(6): 557－564.
[43]	Arora R, Gupta D, Goyal JL, et al. Results of corneal collagen cross－linking in pediatric patients[J]. J Refract Surg, 2012, 28(11): 759－762.
[44]	Raiskup F, Hoyer A, Spoerl E. Permanent corneal haze after riboflavin－UVA－induced cross－linking in keratoconus[J]. J Refract Surg, 2009, 25(9): S824－828.
[45]	Vinciguerra P, Albé E, Frueh BE, et al. Two－year corneal cross－linking results in patients younger than 18 years with documented progressive keratoconus[J]. Am J Ophthalmol, 2012, 154(3): 520－526.
[46]	Antunes－Foschini R, Faria ESSJ. Three－year follow－up in advanced pediatric keratoconus: thin corneas may not have pachymetry properly assessed after crosslinking[J]. Int J Ophthalmol, 2020, 13(10): 1561－1566.
[47]	Sarac O, Caglayan M, Cakmak HB, et al. Factors Influencing Progression of Keratoconus 2 Years After Corneal Collagen Cross－Linking in Pediatric Patients[J]. Cornea, 2016, 35(12): 1503－1507.
[48]	Or L, Rozenberg A, Abulafia A, et al. Corneal Cross－Linking in Pediatric Patients: Evaluating Treated and Untreated Eyes－5－Year Follow－Up Results[J]. Cornea, 2018, 37(8): 1013－1017.
[49]	Mazzotta C, Traversi C, Baiocchi S, et al. Corneal Collagen Cross－Linking With Riboflavin and Ultraviolet A Light for Pediatric Keratoconus: Ten－Year Results[J]. Cornea, 2018, 37(5): 560－566.

Please choose a citation manager

Content to export