Optimal management of pediatric keratoconus: challenges and solutions

Figures & data

Table 1 Challenges in pediatric keratoconus

Late diagnosis

Faster progression

Unsuccessful conservative care

Control of eye rubbing behavior

Accurate tomography

Follow-up

Table 2 Surgical options for pediatric keratoconus

Transepithelial corneal collagen crosslinking Conventional (Dresden protocol) Accelerated Pulsed

Epithelium-off corneal collagen crosslinking Conventional Accelerated Pulsed Topography-guided CXL

Iontophoretic transepithelial crosslinking

Penetrating keratoplasty

Deep anterior lamellar keratoplasty

Sequential intracorneal ring segment ± crosslinking

Abbreviation: CXL, crosslinking.

Table 3 Risk factors in pediatric keratoconus

Lower thinnest corneal thickness

Higher average central corneal keratometry

Increased posterior elevation

Frequent eye rubbing

Allergic eye disorders