View abstract

This abstract is assigned to session BSCRS: Belgian Societies of Cataract and Refractive Surgery

Title	Crosslinking for keratoconus in Down syndrome
Abstract Nr.	348

Purpose	To report on 2 cases of Down syndrome with progressive keratoconus who underwent bilateral simultaneous crosslinking therapy.
Methods	Two male Down syndrome patients of 17 and 20 years old, were diagnosed with progressive keratoconus. Crosslinking therapy was performed to stabilize the cone: after removing the epithelium, application of riboflavin 0,1% solution was performed followed by ultraviolet-A 365 nm light exposure for 30 minutes under general anesthesia.
Results	In the 20 year-old patient both eyes were instilled with hypoosmolar riboflavin solution to achieve swelling of the cornea because of thin corneas on pachymetry. Only one eye was exposed to UV-A light because of the lack of swelling and pachymetry of less than 300µ of the other cornea. Follow-up time was 6 months. Stabilisation in the treated eye could be shown for a follow up period of more than one year. In the other patient standard crosslinking was performed in both eyes. Two days post-crosslinking a corneal ulcus was found in the right eye and intensive antibiotic treatment was applied. A temporary tarsoraphy was necessary because of uncontrollable rubbing of the eye; the patient had to be sedated to allow for examination and treatment of the ulcer. After 4 months of follow-up a paracentral scar persists, while the other eye healed uneventfully.
Conclusion	Keratoconus has been found to be frequently associated with Down syndrome. Progressive keratoconus in patients with Down syndrome can be a good indication for crosslinking to avoid corneal transplant. However follow up and treatment of these patients can be more challenging as the ability to co-operate can vary very much for individuals with Down syndrome.

Author 1

Last name	LEYSEN
Initials	I
Department	UZA
City	Antwerp

Author 2

Last name	KOPPEN
Initials	C
Department	UZA
City	Antwerp

Author 3

Last name	DE VEUSTER
Initials	I
Department	UZA
City	Antwerp

Author 4

Last name	TASSIGNON
Initials	MJ
Department	UZA
City	Antwerp