Simultaneous transepithelial topographic-guided laser and cross-linking to correct irregular astigmatism in a pediatric patient.

PURPOSE: To evaluate an original approach for treating corneal ectasia and irregular astigmatism secondary to penetrating trauma in a pediatric patient.

CASE REPORT: An 11 year old patient had a penetrating trauma in right eye when he was two and the refractive error was +1.50 diopters sphere -6.00 diopters cylinder axis 95°. To correct irregular astigmatism, the patient underwent simultaneous transepithelial topographic-guided laser Central Corneal Remodeling (CCR) and Corneal Cross-linking (CXL) in the attempt to regularize corneal ectasia and to improve the quality of vision. Uncorrected and Corrected Distance Visual Acuity were measured using Efficacy and Safety indexes; objective and subjective qualities of vision were evaluated using respectively corneal morphological irregularity index and National Eye Institute Visual Function questionnaires.

CONCLUSIONS

Twelve month follow up suggests that simultaneous CCR and CXL could be effective to improve the quality of vision and to halt the progression of post-traumatic ectasia in pediatric patients.