title: Pediatric keratoconus and iontophoretic corneal crosslinking: refractive and topographic evidence in patients underwent general and topical anesthesia, 18 months of follow-up.
abstract: To evaluate the efficiency and safety of iontophoretic transepithelial corneal crosslinking in pediatric patients with progressive keratoconus underwent general or topical anesthesia in 18 months follow-up. 13 patients (13 eyes) diagnosed with progressive keratoconus underwent corneal CXL with iontophoresis (I-CXL). Riboflavin solution was administered by iontophoresis for 5 min, and then UV-A irradiation (10 mW/cm) was performed for 9 min. Preoperative and post-operative visits at 1, 6, 12, and 18 months assessed the following parameters: uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA), slit-lamp biomicroscopy, corneal topography, optical tomography, and pachymetry with Pentacam (Oculus Optikgeräte GmbH, Wetzlar, Germany), endothelial biomicroscopy (Konan Specular Microscope; Konan Medical, Inc., Hyogo, Japan). The paired Student t test was used to compare data during the follow-up. 10 males and 3 females with a mean age of 15.4 ± 1.7 years (range 11-18 years) were included. The results showed a stabilization of the refractive UCVA and BCVA as early as the first post-operative month, with a slight improvement over time. The Kmax remained stable throughout follow-up (p = 0.04). Transepithelial collagen crosslinking by iontophoresis, unlike other transepithelial techniques seems to halt pediatric keratoconus progression over 18 months. This is the second study evaluating CXL with iontophoresis in pediatric patients with progressive keratoconus with 18 months of follow-up using two different ways of anesthesia.
authors.affiliation: Pediatric Ophthalmology Department, University of Salerno, AOU "San Giovanni di Dio e Ruggi d'Aragona", Via San Leonardo, 1, Salerno, Italy. amagli@unisa.it.
authors.forename: Adriano
authors.initials: A
authors.lastname: Magli
authors.affiliation: Pediatric Ophthalmology Department, University of Salerno, AOU "San Giovanni di Dio e Ruggi d'Aragona", Via San Leonardo, 1, Salerno, Italy.
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Chiariello Vecchio
authors.affiliation: Pediatric Ophthalmology Department, University of Salerno, AOU "San Giovanni di Dio e Ruggi d'Aragona", Via San Leonardo, 1, Salerno, Italy.
authors.forename: Roberta
authors.initials: R
authors.lastname: Carelli
authors.affiliation: Pediatric Ophthalmology Department, Niguarda Hospital, Milan, Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Piozzi
authors.affiliation: Eye Department, AOU "San Giovanni di Dio e Ruggi d'Aragona", Via San Leonardo, 1, Salerno, Italy.
authors.forename: Felicia
authors.initials: F
authors.lastname: Di Landro
authors.affiliation: Eye Department, AOU "San Giovanni di Dio e Ruggi d'Aragona", Via San Leonardo, 1, Salerno, Italy.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Troisi
mesh_terms: D000293:Adolescent; D002452:Cell Count; D002648:Child; D003094:Collagen / Q000378:metabolism; D063171:Corneal Pachymetry; D003319:Corneal Stroma / Q000378:metabolism*; D003432:Cross-Linking Reagents; D004728:Endothelium, Corneal / Q000473:pathology; D005260:Female; D006801:Humans; D007478:Iontophoresis / Q000379:methods*; D007640:Keratoconus / Q000188:drug therapy* / Q000378:metabolism; D008297:Male; D010778:Photochemotherapy; D017319:Photosensitizing Agents / Q000627:therapeutic use*; D012256:Riboflavin / Q000627:therapeutic use*; D041623:Tomography, Optical Coherence; D014466:Ultraviolet Rays; D014792:Visual Acuity / Q000502:physiology
chemical_list: D003432:Cross-Linking Reagents; D017319:Photosensitizing Agents; D003094:Collagen; D012256:Riboflavin
keywords: Cornea; Crosslinking; Keratoconus; Pediatric