Comparison of Corneal Tomography Parameters in the Diagnosis of Keratoconus in Early and Late Pediatric Age Group.

Purpose: The purpose of this study was to examine demographic and tomographic parameters in pediatric patients diagnosed with keratoconus and to evaluate the difference between early and late age periods.

Methods: This retrospective study included patients younger than 18 years of age who were diagnosed with keratoconus. All examination findings, demographic data, tomography parameters, and keratoconus stages were recorded. The patients were divided into two groups: 14 years or younger (Group 1) and those between 14 and 18 years old (Group 2). All corneal tomography parameters were compared in the subgroups and were evaluated statistically. P <0.05 was considered statistically significant.

Results: A total of 131 eyes of 71 patients were included. The mean age was 15.7 ± 1.8 (range, 10-18) years, and the female-to-male ratio was 23/48. The mean best spectacle-corrected visual acuity was 0.36 ± 0.44 (range, 0-3.1) logMAR. The averages of K1, K2, Km, and Kmax were 49.0 ± 6.2 (range, 39.6-74.5) D, 53.5 ± 7.0 (range, 43.3-76.8) D, 51.3 ± 6.5 (range, 41.5-75) D, and 59.1 ± 9.0 (range, 44.7-85.2) D, respectively, and the mean central corneal thickness (CCT) was 456.9 ± 63.5 µm (range, 261-601). The distribution of eyes with keratoconus from stages 1-4 was 5.3%, 36.6%, 38.9%, and 19.1%, respectively. When the groups were compared, K1, K2, Km, and Kmax were significantly steeper in Group 1 compared to Group 2 (P = 0.006, P = 0.004, P = 0.004, and P = 0.007, respectively). CCT and the thinnest corneal thickness values were significantly less in Group 1 (P = 0.038 and P = 0.041, respectively).

Conclusion: The decision for treatment - especially cross-linking - should be made at the right time due to the increased risk of progression in the earlier ages in pediatric keratoconus population.