Skip to main content

Advertisement

SpringerLink
Log in

Pediatric keratoconus: a review of the literature

  • Review
  • Published:
International Ophthalmology Aims and scope Submit manuscript

Abstract

Purpose

To describe the epidemiology and prevalence, rates of progression, difference between adult and pediatric populations, and therapeutic approaches to pediatric keratoconus from documented literature.

Methods

A literature search was done on PubMed using key words including pediatric keratoconus, children with keratoconus, adult keratoconus, penetrating keratoplasty, corneal cross-linking and intracorneal ring segments. The literature was reviewed and reported to explore the key epidemiological differences between the pediatric and adult population with regards to presentation and treatment options.

Results

Pediatric keratoconus is more aggressive than adult keratoconus, which has been explained by structural differences in the cornea between both populations. High rates of progression were documented in pediatric populations. While corneal collagen cross-linking, intracorneal ring segments and penetrating keratoplasties have been used as therapies in the pediatric population, the literature overwhelmingly shows higher rates of failure and progression despite these measures as compared to adults.

Conclusion

Pediatric keratoconus is more aggressive than adult keratoconus, and current therapies used in adults may not be sufficient for the pediatric population.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Kankariya VP, Kymionis GD, Diaknois VF et al (2013) Management of pediatric keratoconus—evolving role of corneal collagen cross-linking: an update. Ind J Ophthalmol 61(8):435–440

    Article  Google Scholar 

  2. Tuf SJ, Moodaley LC, Gregory WM et al (1994) Prognostic factors for the progression of keratoconus. Ophthalmology 101:439–447

    Article  Google Scholar 

  3. Ys R (1998) Keratoconus. Surv Ophthalmol 42:297–319

    Article  Google Scholar 

  4. El Rami H, Chelala E, Dirani A et al (2015) An update on the safety and efficacy of corneal collagen cross-linking in pediatric keratoconus. BioMed Res Int

  5. Raiskup-Wolf F, Hoyer A, Spoerl E et al (2008) Collagen crosslinking with riboflavin and ultraviolet—a light in keratoconus: long term results. J Cataract Refract Surg 34(5):796–801

    Article  PubMed  Google Scholar 

  6. Sabti S, Tappeiner C, Frueh BE (2015) Corneal Cross-linking in a 4-year old child with keratoconus and down syndrome. Cornea 34(9):1157–1160

    Article  PubMed  Google Scholar 

  7. Jonas JB, Nangia V, Matin A et al (2009) Prevalence and associations of keratoconus in rural Maharashtra in central India: the Central India Eye and Medical Study. Am J Ophthalmol 148(5):760–765

    Article  PubMed  Google Scholar 

  8. Millodot M, Shneor E, Albou S et al (2011) Prevalence and associated factors of keratoconus in Jerusalem: a cross-sectional study. Ophthalmic Epidemiol 18(2):91–97

    Article  PubMed  Google Scholar 

  9. Wakend N, Fayad AM, Fadlallah A et al (2012) Keratoconus screening in Lebanese students’ population. J Fr Ophthalmol 35(1):23–29

    Article  Google Scholar 

  10. Xu L, Wang YX, Guo Y et al (2012) Prevalence and associations of steep cornea/keratoconus in greater Beijing. The Beijing Eye Study. PLoS ONE 7(7):e39313

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Hashemi H, Khabazkhoob M, Fotouhi A (2013) Topographic keratoconus is not rare in an Iranian population: the Tehran eye study. Ophthalmic Epidemiol 20(6):385–391

    Article  PubMed  Google Scholar 

  12. Hashemi H, Khabazkhoob M, Yazdani N et al (2014) The prevalence of keratoconus in a young population in Mashad. Iran Ophthalmic Physiol Opt 34(5):519–527

    Article  PubMed  Google Scholar 

  13. Shneor E, Millodot M, Gordon-Shaag A et al (2014) Prevalence of keratoconus among young Arab students in Israel. Int J Kerato Ectatic Corneal Dis 3(1):9–14

    Article  Google Scholar 

  14. Hashemi H, Beiranvand A, Khabazkhoob M et al (2013) Prevalence of keratoconus in a population-based study in Shahroud. Cornea 32(11):1441–1445

    Article  PubMed  Google Scholar 

  15. Pearson AR, Soneji B, Sarvananthan N et al (2000) Does ethnic origin influence the incidence or severity of keratoconus? Eye 14:625–628

    Article  PubMed  Google Scholar 

  16. Georgious T, Funnell CL, Cassels-Brown A et al (2004) Influence of ethnic origin on the incidence of keratoconus and associated atopic disease in Asians and white patients. Eye 18(4):383–397

    Google Scholar 

  17. Cozma I, Atherley C, James NJ et al (2005) Influence of ethnic origin on the incidence of keratoconus and associated atopic disease in Asian and white patients. Eye 19(8):924–926

    Article  CAS  PubMed  Google Scholar 

  18. Pan CW, Cheng CY, Sanayagam C et al (2014) Ethnic variation in central corneal refractive power and steep cornea in Asians. Ophthalmic Epidemiol 21(2):99–105

    Article  PubMed  Google Scholar 

  19. Gordon Shaag A, Millodot M, Shneor E et al (2015) The genetic and environmental factors for keratoconus. BioMed Res Int 19

  20. Li X, Rabinowitz YS, Rasheed K et al (2004) Longitudinal study of the normal eyes in unilateral keratoconus patients. Ophthalmology 111(3):440–446

    Article  PubMed  Google Scholar 

  21. Lema I, Duran JA, Ruiz C, Diez-Feijoo E, Acera A, Merayo J (2008) Inflammatory response to contact lenses in patients iwth keratoconus compared with myopic subjects. Cornea 27:758–763

    Article  PubMed  Google Scholar 

  22. Lema I, Sobrino T, Duran JA et al (2009) Subclinical keratoconus and inflammatory molecules from tears. Br J Ophthalmol 93(6):820–824

    Article  CAS  PubMed  Google Scholar 

  23. Mackiewicz ZMM, Stenman M, Konttinen L, Tervo T, Konttinen YT (2006) Collagenolytic proteinases in keratoconus. Cornea 25:603–610

    Article  PubMed  Google Scholar 

  24. Pouliquen Y, Bureau J, Mirshahi M, Mirshahi SS, Assouline M, Lorens G (1996) Keratoconus and inflammatory processes. Bull Soc Belge Ophthalmol 262:25–28

    CAS  Google Scholar 

  25. Bauman KA, Wettlaufer SH, Okunishi K et al (2010) The antifibrotic effects of plasminogen activation occur via prostaglandin E2 synthesis in humans and mice. J Clin Invest 120:1950–1960

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  26. Balasubramanian SA, Wasinger VC, Pye DC, Willcox MD (2013) Preliminary identification of differentially expressed tear proteins in keratoconus. Mol Vis 19:2124–2134

    CAS  PubMed  PubMed Central  Google Scholar 

  27. Acera A, Vecino E, Rodriquez-Agirretxe I et al (2011) Changes in tear protein profile in keratoconus disease. Eye (Lond) 25:1225–1233

    Article  CAS  Google Scholar 

  28. Cheung IM, McGee CN, Sherwin T (2013) A new perspective on the pathobiology of keratoconus: interplay of stromal wound healing and reactive species-associated processes. Clin Exp Ophthalmol 96:188–196

    Google Scholar 

  29. Jun AS, Cope L, Speck C et al (2011) Subnormal cytokine profile in the tear fluid of keratoconus patients. PLoS ONE 6(1):e16437

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  30. Wojcik KA, Blasiak J, Szaflik J, Szaflik JP (2014) Role of biochemical factors in the pathogenesis of keratoconus. Acta Biochem Polonica 61:55–62

    Google Scholar 

  31. Davidson AE, Hayes S, Hardcastle AJ et al (2014) The pathogenesis of keratoconus. Eye 28(2):189–195

    Article  CAS  PubMed  Google Scholar 

  32. Leoni-Mesplie S, Mortemousque B, Mesplie N et al (2012) Epidemiologcal aspects of keratoconus in children. Fr J Ophthalmol 35(10):776–785

    Article  CAS  Google Scholar 

  33. Balasubramanian SAPD, Wilcox MD (2013) Effects of eye rubbing on the levels of protease, protease activity and cytokines in tears: relevance in keratoconus. Clin Exp Ophthalmol 96:214–218

    Google Scholar 

  34. Gonzales V, McDonnell PJ (1992) Computer-assisted corneal topography in parents of patients with keratoconus. Arch Ophthalmol 110(10):1412–1414

    Article  Google Scholar 

  35. Rabinowitz YS, Garbus J, McDonnell PJ (1990) Computer-assisted corneal topography in family members of patients with keratoconus. Arch Ophthalmol 108(3):365–371

    Article  CAS  PubMed  Google Scholar 

  36. Caputo R, Versaci F, Pucci N, de Libero C et al (2016) Very low prevalence of keratoconus in a large series of vernal keratoconjunctivitis patients. Am J Ophthalmol 172:64–71

    Article  PubMed  Google Scholar 

  37. Adachi W, Mitsuishi Y, Terai K et al (2002) The association of HLA with young-onset keratoconus in Japan. Am J Ophthalmol 133:557–559

    Article  PubMed  Google Scholar 

  38. Kamiya K, Shimizu K, Ohmoto F (2009) Effect of aging on corneal biochemical parameters using the ocular response analyzer. J Refract Surg 25:888–893

    Article  PubMed  Google Scholar 

  39. Rehany U, Rumelt S (1995) Corneal hydrops associated with vernal conjunctivitis as a presenting sign of keratoconus in children. Ophthalmology 102(12):2046–2049

    Article  CAS  PubMed  Google Scholar 

  40. Reeves SW, Stinnett S, Adelman RA et al (2005) Risk factors for progression to penetrating keratoplasty in patients with keratoconus. Am J Ophthalmol 140(4):607-e601–607-e606

    Article  Google Scholar 

  41. Kotecha A, Elsheikh A, Robertsr C et al (2006) Corneal thickness and age-related biomechanical properties of the cornea measured with the ocular response analyzer. Invest Ophthalmol Vis Sci 47:5337–5347

    Article  PubMed  Google Scholar 

  42. Ertan A, Muftuoglu O (2008) Keratoconus clinical findings according to different age and gender groups. Cornea 27:1109–1113

    Article  PubMed  Google Scholar 

  43. Gordon MO, Steger-May KLS-F et al (2006) Baseline factors predictive of incident penetrating keratoplasty in keratoconus. Am J Ophthalmol 142(6):923–930

    Article  PubMed  Google Scholar 

  44. Amsler M (1961) Quelques donnees du problem. Bull Soc Belge Ophthalmol 129:331–334

    CAS  Google Scholar 

  45. Chatzis N, Hafezi F (2012) Progression of keratoconus and efficiency of pediatric [corrected] corneal collagen cross-linking in children and adolescents. J Refract Surg 28(11):753–758

    Article  PubMed  Google Scholar 

  46. McMahon TT, Edrington TB, Szczotka-Flynn L et al (2006) Longitudinal changes in corneal curvature in keratoconus. Cornea 25:296–305

    Article  PubMed  Google Scholar 

  47. Dana MR, Putz JL, Viana MA et al (1992) Contact lens failure in keratoconus management. Ophthalmology 99(8):1187–1192

    Article  CAS  PubMed  Google Scholar 

  48. Pouliquen Y, Forman MR, Giraud JP (1981) Vitnesse d’evolution du keratocone: etude des relations entre l’age de decourverte et l’age auguel il est opra. Fr J Ophthalmol 4:219–221

    CAS  Google Scholar 

  49. Lass JH, Lembach RG, Park SB et al (1990) Clinical management of keratoconus: a multicenter analysis. Ophthalmology 90:433–445

    Article  Google Scholar 

  50. Kennedy RHBW, Dyer JA (1986) A 48-year clinical and epidemiologic study of keratoconus. Am J Ophthalmol 101:267–273

    Article  CAS  PubMed  Google Scholar 

  51. Woodward EG, Moodely LC, O’Hagan A (1990) Predictors for likelihood of corneal transplantation in keratoconus. Eye 4:493–496

    Article  PubMed  Google Scholar 

  52. Hamilton A, Wong S, Carley F et al (2015) Tomographic indices as possible risk factors for progression in pediatric keratoconus. J AAPOS 20:523–526

    Article  Google Scholar 

  53. Léoni-Mesplié SMB, Touboul D et al (2012) Scalability and severity of kertoconus in children. Am J Ophthalmol 154(1):56–62

    Article  PubMed  Google Scholar 

  54. Soeters N, van der Valk R, Tahzib NG (2014) Corneal cross-linking for treatment of progressive keratoconus in various age groups. J Refract Surg 30(7):454–460

    Article  PubMed  Google Scholar 

  55. Vinciguerra P, Albe E, Frueh BE et al (2012) Two year corneal cross-linking results in patients younger than 18 years with documented progressive keratoconus. Am J Ophthalmol 154(3):520–526

    Article  PubMed  Google Scholar 

  56. Theuring A, Spoerl E, Pillunat LE et al (2015) Corneal collagen cross-linking with riboflavin and ultraviolet—A light in progresive keratoconus. Results after 10-year follow-up. Ophthalmologe 112(2):140–147

    Article  CAS  PubMed  Google Scholar 

  57. Vinciguerra R, Romano M, Carnesasca F et al (2013) Corneal cross-linking as a treatment for keratoconus: four-year morphologic and clinical outcomes with respect to patient age. Ophthalmology 120:908–918

    Article  PubMed  Google Scholar 

  58. Caporossi A, Mazzotta C, Baiocchi S et al (2011) Age-related long term functional results after riboflavin UVA corneal crosslinking. Am J Ophthalmol. doi:10.1155/2011/608041

    Article  CAS  Google Scholar 

  59. Ivarsen A, Hjortdal J (2013) Collagen cross-linking for advanced progressive keratoconus. Cornea 32(7):903–906

    Article  PubMed  Google Scholar 

  60. Low JR, Anshu A, Tan AC et al (2014) The outcomes of primary pediatric keratoplasty in Singapore. Am J Ophthalmol 158(3):496–502

    Article  PubMed  Google Scholar 

  61. Waring GO, Laibson PR (1977) Keratoplasty in infants and children. Trans Sect Otolaryngol Am Acad Ophthalmol Otolaryngol 83(2):283–296

    Google Scholar 

  62. Asuri MK, Garg P, Gokhle N et al (2000) Penetrating keratoplasty n children. Cornea 19(2):140–144

    Article  Google Scholar 

  63. Lowe MT, Keane MC, Coster DJ et al (2011) The outcome of corneal transplantation in infants, children, and adolescents. Ophthalmology 118(3):492–497

    Article  PubMed  Google Scholar 

  64. Patel HY, Ormonde S, Brookes NH et al (1991–2003) The indications and outcome of pediatric corneal transplantation in New Zealand. Br J Ophthalmol 89(4):404–408

  65. Cowden JW (1990) Penetrating keratoplasty in infants and children. Ophthalmology 97(3):324–328

    Article  CAS  PubMed  Google Scholar 

  66. Arora R, Gupta D, Goyal JL et al (2012) Results of corneal collagen cross-linking in pediatric patients. J Refract Surg 28:759–762

    Article  PubMed  Google Scholar 

  67. Wise S, Diaz C, Termote K et al (2016) Corneal cross-linking in pediatric patients with progressive keratoconus. Cornea 35(11):1441–1443

    Article  PubMed  Google Scholar 

  68. Bakshi E, Barkana Y, Goldich Y et al (2012) Corneal cross-linking for progressive keratoconus in children: our experience. Int J Kerato Ectatic Corneal Dis 1:53–56

    Article  Google Scholar 

  69. Toprak I, Yaylali V, Yildrim C (2016) Visual, topographic, and pacchymetric effects of pediatric corneal collagen cross-linking. J Pediatr Ophthalmol Strabismus 54:84–89

    Article  PubMed  Google Scholar 

  70. Sarac O, Caglayan M, Cakmak HB (2016) Factors influencing progresison of keratoconus 2 years after corneal collagen cross-linking in pediatric patients. Cornea (EPub ahead of print)

  71. Caporossi A, Mazzotta C, Baiocchi S et al (2012) Riboflavin-UVA-induced corneal collagen cross-linking in pediatric patients. Cornea 31:227–231

    Article  PubMed  Google Scholar 

  72. Zota PGMK, Diaknois VF et al (2012) Corneal collagen cross-linking for progressive keratoconus in pediatric patients: a feasibility study. J Refract Surg 28:793–799

    Article  Google Scholar 

  73. Padmanabhan P, Rachapalle R, Rajagopal R et al (2017) Corneal Collagen cross-linking for keratoconus in pediatric patients—long-term results. Cornea 36:138–142

    Article  PubMed  Google Scholar 

  74. Ucakhan OO, Bayraktutar BN, Saglik A (2016) Pediatric corneal collagen cross-linking: long term follow up of visual, refractive and topographic outcomes. Cornea 35:162–168

    Article  PubMed  Google Scholar 

  75. Godefrooji DA, Soeters N, Imhof SM, Wisse RP (2016) Corneal cross-linking for pediatric keratoconus: long term results. Cornea 35(7):954–958

    Article  Google Scholar 

  76. Kodavoor KS, Ariswala AZ, Ramamurthy D (2014) One year clinical study of efficacy of corneal cross-linking in Indian children with progressive keratoconus. Cornea 33(9):919–922

    Article  Google Scholar 

  77. Mazzotta C, Balestrazze A, Baiocchi S et al (2007) Stromal haze after combined riboflavin-UVA corneal collagen cross-linking in keratoconus: in vivo confocal microscopic evaluation. Clin Exp Ophthalmol 35:580–582

    Article  PubMed  Google Scholar 

  78. Zamora KV, Males JJ (2009) Polymicrobial keratitis after a collagen crosslinking procedure with postoperative use of a contact lens: a case report. Cornea 28:474–476

    Article  PubMed  Google Scholar 

  79. Vinciguerra P, Albe E, Trazza S et al (2009) Refractive, topographic, tomographic, and aberrometric analysis of keratoconic eyes undergoing corneal cross-linking. Ophthalmology 116:369–378

    Article  PubMed  Google Scholar 

  80. Caporossi A, Mazzotta C, Baiocchi S et al (2010) Long-term results of riboflavin ultraviolet corneal cross-linking for keratoconus in Italy: the Siena eye cross study. Am J Ophthalmol 149:585–593

    Article  CAS  PubMed  Google Scholar 

  81. Buzzonetti L, Petrocelli G, Valente P et al (2015) Ionophoretic transepithelial CXL to halt keratoconus in pediatric cases. Cornea 34:512–515

    Article  PubMed  Google Scholar 

  82. Magli A, Forte R, Tortori A et al (2013) Epithelium-off corneal collagen cross-linking versus transepithelial cross-linking for pediatric keratoconus. Cornea 32:597–601

    Article  PubMed  Google Scholar 

  83. Caporossi A, Mazzotta C, Paradiso A et al (2013) Transepithelial corneal collagen crosslinking for progressive keratoconus: 24 month clinical results. J Cataract Refract Surg 39:1157–1163

    Article  PubMed  Google Scholar 

  84. Ag S (2016) Corneal Biomechanical and anterior chamber parameteres variations after 1-year of transepithelial corneal cross-linking in eyes of children with keratoconus. Middle East Afr J Ophthlamol 23:129–134

    Article  Google Scholar 

  85. Erasalan M, Toker E, Cerman E et al (2016) Efficacy of epithelium-off and epithelium-on corneal cross linking in pediatric keratoconus. Eye Contact Lens 43:155–161

    Article  Google Scholar 

  86. Alio JL, Shabayek MH, Artola A (2006) Intracorneal ring segments for keratoconus correction: long term follow-up. J Cataract Refract Surg 32:978–985

    Article  PubMed  Google Scholar 

  87. Dirani A, Fadlallah A, Khoueir Z et al (2013) Safety and efficacy of intacts intracorneal ring segment implantation to improve best corrected visual acuity in children with keratoconus. Eur Soc Cataract and Refract Surg (Abstract) Amsterdam, Netherlands

  88. Antoun J, Slim E, El Rami H et al (2015) Pediatric keratoconus in a tertiary referral center: prevalence, presentation, risk factors and treatment. Eur Soc Cataract Refract Surg

  89. Coskunseven E, Jankov MR II, Hafezi F et al (2009) Effect of treatment sequence in combined intrastromal corneal rings and corneal collagen crosslinking for keratoconus. J Cataract Refract Surg 35:2084–2091

    Article  PubMed  Google Scholar 

  90. El-Raggal TM (2011) Effect of corneal collagen crosslinking on femtosecond laser channel creation for intrastromal corneal ring segment implantation in keratoconus. J Cataract Refract Surg 37:701–705

    Article  PubMed  Google Scholar 

  91. Kilic A, Kamburoglu G, Akinci A (2012) Riboflavin injection into the corneal channel for combined collagen crosslinking and intrastromal corneal ring segment implantation. J Cataract Refract Surg 38:878–883

    Article  PubMed  Google Scholar 

  92. Yeung SN, Low SA, Ku JY et al (2013) Transepithelial phototherapeutic keratectomy combined with implantation of a single inferior intrastromal corneal ring segment and collagen crosslinking in keratoconus. J Cataract Refract Surg 39:1152–1156

    Article  PubMed  Google Scholar 

  93. Gaster RN, Caiado Canedo AL, Rabinowitz YS (2013) Corneal collagen cross-linking for keratoconus and post-LASIK ectasia. Int Ophthalmol Clin 53:79–90

    Article  PubMed  PubMed Central  Google Scholar 

  94. Ertan A, Kamburoglu G, Bahadir M (2006) Intacs insertion with the femtosecond laser for the management of keratoconus. One year results. J Cataract Refract Surg 32:2039–2042

    Article  PubMed  Google Scholar 

  95. Kanellopuolos AJ, Pe LH, Perry HD et al (2006) Modified intracorneal ring segment implantations (Intacs) for the management of moderate to advanced keratoconus. Efficacy and complications. Cornea 25:29–33

    Article  Google Scholar 

  96. Kwitko S, Severo NS (2004) Ferrara intracorneal ring segments for keratoconus. J Cataract Refract Surg 30:812–820

    Article  PubMed  Google Scholar 

  97. Shetty R, Kurian M, Anand D et al (2008) Intacs in advanced keratoconus. Cornea 27:1022–1029

    Article  PubMed  Google Scholar 

  98. Ertan A, Kamburoglu G, Bahadir M (2008) Intacts implantation using femtosecond laser for management of keratoconus: comparison of 306 cases in different stages. J Cataract Refract Surg 34:1521–1526

    Article  PubMed  Google Scholar 

  99. Shabayek MH, Alio JL (2007) Intrastromal corneal ring segment implantation by femtosecond laser for keratoconus correction. Ophthalmology 114:1643–1652

    Article  PubMed  Google Scholar 

  100. Zare MA, Hasemi H, Salari MR (2007) Intracorneal ring segment implantation for management of keratoconus: safety and efficacy. J Cataract Refract Surg 33:1886–1891

    Article  PubMed  Google Scholar 

  101. Kymionis GD, Siganos CS, Tsiklis NS et al (2007) Long-term follow up of Intacs in keratoconus. Am J Ophthalmol 143:236–244

    Article  PubMed  Google Scholar 

  102. Colin J (2006) Europoean clinical evaluation: use of Intacs for the treatment of keratoconus. J Cataract Refract Surg 32:747–755

    Article  PubMed  Google Scholar 

  103. Siganos CS, Kymionis GD, Kartikis N, Theodorakis MA, Astyrakakis N, Pallikaris IG (2003) Management of keratoconus with Intact. Am J Ophthalmol 135:64–70

    Article  CAS  PubMed  Google Scholar 

  104. Kymionis GD, Siganos CS, Kounis G et al (2003) Management of post-LASIK corneal ectasia with Intacs inserts. One-year results. Arch Ophthalmol 121:322–326

    Article  PubMed  Google Scholar 

  105. Alio JL, Artola A, Hassanein A et al (2005) One or 2 Intacs segments for the correction of keratoconus. J Cataract Refract Surg 31:943–953

    Article  PubMed  Google Scholar 

  106. Al-Torbak A, Al-Amri A, Wagoner MD (2005) Deep corneal neovascularization after implantation with instrastromal corneal ring segments. Am J Ophthalmol 140:926–927

    Article  PubMed  Google Scholar 

  107. Carrasquillo KG, Rand J (2007) JH T. Intacs for keratoconus and post-LASIK ectasia: mechanical versus femtosecond laser-assisted channel. Cornea 26:956–962

    Article  PubMed  Google Scholar 

  108. Deobhakta AA, Kymionis GD, Ide T et al (2008) Corneal edema after Intacs implantation with the femtosecond laser. J Cataract Refract Surg 34:174

    Article  PubMed  Google Scholar 

  109. Al Suhaibani AH, Al-Rajhi AA, Al-Motowa S et al (2007) Inverse relationship between age and severity sequelae of acute corneal hydrops associated with keratoconus. Br J Ophthalmol 7(9):984–985

    Article  Google Scholar 

  110. Adachi W, Kinoshita S, Kobayashi Y et al (2001) First mouse model of hereditary keratoconus: androgen dependency and mapping to chromosome 17. Invest Ophthalmol Vis Sci 42:S906

    Google Scholar 

  111. Bodenmueller M, Goldblum D, Frueh BE (2003) Penetrating keratoplasty in Down’s Syndrome. Klin Monbl Augenheilkd 220:99–102 (in German)

    Article  PubMed  Google Scholar 

  112. Vanathi M, Panda A, Vengayil S et al (2009) Pediatric keratoplasaty. Surv Ophthalmol 54(2):245–271

    Article  CAS  PubMed  Google Scholar 

  113. Huang C, O’Hara M, Mannis MJ (2009) Primary pediatric keratoplasty: indications and outcomes. Cornea 28(9):1003–1008

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. School of Medicine, Virginia Commonwealth University, 1201 E. Marshall St., 4th Floor, Richmond, VA, 232983, USA

    Sabrina Mukhtar

  2. Moran Eye Center, University of Utah, 64 Mario Capecchi Dr, Salt Lake City, UT, 84132, USA

    Balamurali K. Ambati

Authors
  1. Sabrina Mukhtar
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Balamurali K. Ambati
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Sabrina Mukhtar.

Ethics declarations

Conflict of interest

None of the authors have conflicts of interests with submission.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Mukhtar, S., Ambati, B.K. Pediatric keratoconus: a review of the literature. Int Ophthalmol 38, 2257–2266 (2018). https://doi.org/10.1007/s10792-017-0699-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10792-017-0699-8

Keywords

Search

Navigation