Corneal Cross-Linking for Paediatric Keratoconus: A Systematic Review and Meta-Analysis

All corneal cross-linking techniques attenuated disease progression in patients with pediatric keratoconus for at least one year based on a meta-analysis. A standard and accelerated technique led to marked improvement in visual acuity. We determined the efficacy and safety of corneal cross-linking (...

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Main Authors: Hidenaga Kobashi, Osamu Hieda, Motohiro Itoi, Kazutaka Kamiya, Naoko Kato, Jun Shimazaki, Kazuo Tsubota, the Keratoconus Study Group of Japan
Format: Article
Language:English
Published: MDPI AG 2021-06-01
Series:Journal of Clinical Medicine
Subjects:
Online Access:https://www.mdpi.com/2077-0383/10/12/2626
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author Hidenaga Kobashi
Osamu Hieda
Motohiro Itoi
Kazutaka Kamiya
Naoko Kato
Jun Shimazaki
Kazuo Tsubota
the Keratoconus Study Group of Japan
author_facet Hidenaga Kobashi
Osamu Hieda
Motohiro Itoi
Kazutaka Kamiya
Naoko Kato
Jun Shimazaki
Kazuo Tsubota
the Keratoconus Study Group of Japan
author_sort Hidenaga Kobashi
collection DOAJ
description All corneal cross-linking techniques attenuated disease progression in patients with pediatric keratoconus for at least one year based on a meta-analysis. A standard and accelerated technique led to marked improvement in visual acuity. We determined the efficacy and safety of corneal cross-linking (CXL) in pediatric keratoconus by conducting a systematic review and meta-analysis. The PubMed and Cochrane databases were searched for relevant studies on the effects of standard, transepithelial, and/or accelerated CXL protocols in patients aged 18 years or younger. Standardized mean differences with 95% confidence intervals were calculated to compare the data collected at baseline and 12 months. The primary outcomes were maximum keratometry (Kmax) and uncorrected visual acuity (UCVA), and the secondary outcomes were the thinnest corneal thickness (TCT), best-corrected visual acuity (BCVA), and manifest refraction spherical equivalent or cylindrical refraction. Our search yielded 7913 publications, of which 26 were included in our systematic review and 21 were included in the meta-analysis. Standard CXL significantly improved the Kmax, UCVA, and BCVA, and significantly decreased the TCT. Accelerated CXL significantly improved UCVA and BCVA. In the transepithelial and accelerated-transepithelial CXL methods, each measurable parameter did not change after treatments. All CXL techniques attenuated disease progression in patients with pediatric keratoconus for at least one year. Standard and accelerated CXL led to marked improvement in visual acuity.
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spelling doaj.art-a33a56db37e84c9ca0b6746b75c1e0122023-11-22T00:07:47ZengMDPI AGJournal of Clinical Medicine2077-03832021-06-011012262610.3390/jcm10122626Corneal Cross-Linking for Paediatric Keratoconus: A Systematic Review and Meta-AnalysisHidenaga Kobashi0Osamu Hieda1Motohiro Itoi2Kazutaka Kamiya3Naoko Kato4Jun Shimazaki5Kazuo Tsubota6the Keratoconus Study Group of JapanDepartment of Ophthalmology, School of Medicine, Keio University, Tokyo 160-8582, JapanDepartment of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto 602-8566, JapanDepartment of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto 602-8566, JapanDepartment of Ophthalmology, School of Medicine, University of Kitasato, Kanagawa 252-0329, JapanDepartment of Ophthalmology, School of Medicine, Keio University, Tokyo 160-8582, JapanDepartment of Ophthalmology, Ichikawa General Hospital, Tokyo Dental College, Chiba 272-8513, JapanDepartment of Ophthalmology, School of Medicine, Keio University, Tokyo 160-8582, JapanAll corneal cross-linking techniques attenuated disease progression in patients with pediatric keratoconus for at least one year based on a meta-analysis. A standard and accelerated technique led to marked improvement in visual acuity. We determined the efficacy and safety of corneal cross-linking (CXL) in pediatric keratoconus by conducting a systematic review and meta-analysis. The PubMed and Cochrane databases were searched for relevant studies on the effects of standard, transepithelial, and/or accelerated CXL protocols in patients aged 18 years or younger. Standardized mean differences with 95% confidence intervals were calculated to compare the data collected at baseline and 12 months. The primary outcomes were maximum keratometry (Kmax) and uncorrected visual acuity (UCVA), and the secondary outcomes were the thinnest corneal thickness (TCT), best-corrected visual acuity (BCVA), and manifest refraction spherical equivalent or cylindrical refraction. Our search yielded 7913 publications, of which 26 were included in our systematic review and 21 were included in the meta-analysis. Standard CXL significantly improved the Kmax, UCVA, and BCVA, and significantly decreased the TCT. Accelerated CXL significantly improved UCVA and BCVA. In the transepithelial and accelerated-transepithelial CXL methods, each measurable parameter did not change after treatments. All CXL techniques attenuated disease progression in patients with pediatric keratoconus for at least one year. Standard and accelerated CXL led to marked improvement in visual acuity.https://www.mdpi.com/2077-0383/10/12/2626keratoconuscorneal cross-linkingpediatric
spellingShingle Hidenaga Kobashi
Osamu Hieda
Motohiro Itoi
Kazutaka Kamiya
Naoko Kato
Jun Shimazaki
Kazuo Tsubota
the Keratoconus Study Group of Japan
Corneal Cross-Linking for Paediatric Keratoconus: A Systematic Review and Meta-Analysis
Journal of Clinical Medicine
keratoconus
corneal cross-linking
pediatric
title Corneal Cross-Linking for Paediatric Keratoconus: A Systematic Review and Meta-Analysis
title_full Corneal Cross-Linking for Paediatric Keratoconus: A Systematic Review and Meta-Analysis
title_fullStr Corneal Cross-Linking for Paediatric Keratoconus: A Systematic Review and Meta-Analysis
title_full_unstemmed Corneal Cross-Linking for Paediatric Keratoconus: A Systematic Review and Meta-Analysis
title_short Corneal Cross-Linking for Paediatric Keratoconus: A Systematic Review and Meta-Analysis
title_sort corneal cross linking for paediatric keratoconus a systematic review and meta analysis
topic keratoconus
corneal cross-linking
pediatric
url https://www.mdpi.com/2077-0383/10/12/2626
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