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Keratoconus progression following collagen cross-linking treatment in the paediatric population: what are the predicting factors?

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Session Details

Session Title: Presented Poster Session: Cross-Linking

Venue: Poster Village: Pod 2

First Author: : J.Warbey UK

Co Author(s): :    S. Hamada                       

Abstract Details


Collagen cross-linking treatment (CXL) is an effective method in halting disease progression in the keratoconus population. The success of CXL treatment is variable and typically fails more often within the paediatric population where the disease is believed to be more aggressive. The aim of this study was to compare the differences in presenting factors and symptoms of paediatric keratoconus patients who underwent CXL treatment.


Corneo-Plastic Unit and Eye Bank, Queen Victoria Hospital NHS Trust, East Grinstead, UK


Ninety-seven eyes from 57 patients with keratoconus who underwent CXL treatment were included in this retrospective study. Pre-operative measurements of past medical history, history of atopic disease, familial history of keratoconus, clinical signs of keratoconus, uncorrected visual acuity, keratometric readings, central corneal thickness, and thinnest corneal pachymetry were evaluated. The eyes were divided into two groups, those that were treated with CXL once, and those who required repeat CXL to halt disease progression. Odds ratios were used for statistical analysis. P<0.05 was considered statistically significant.


The mean age was 14.63+/-1.43 years with all patients receiving CXL treatment, of which 12.4% required additional CXL treatment within the 1-year follow up period. No statistically significant differences were present in pre-operative measurements discussed above between the two subgroups. Disease severity (determined by mean keratometry values, Km) was not associated with an increased risk of CXL treatment failure (p=0.103).


Our paediatric keratoconus population had increased rates of CXL treatment failure compared to the adult population seen in the literature, thought to be due in part to a more aggressive disease state seen within this group as well as the longer age group. According to our research there were no pre-treatment differences found between the two groups, therefore the studied factors will not elucidate to clinicians which patients are likely to need repeated CXL treatment. More research is required in order to determine why CXL treatment failure rates are higher within the paediatric population.

Financial Disclosure:


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