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    Conjunctival Impression Cytology and Tear Function in Patients with Keratoconus
    (2021) Özcan, Deniz Özarslan; Özcan, Sait Coşkun; Gürsoy, Didar
    Objectives: The aim of this study was to evaluate the ocular surface alterations of conjunctival cytological changes and tear function in patients with keratoconus. Methods: A total of 98 eyes with keratoconus and 68 eyes of age- and sex- matched healthy subjects were included in this prospective study. Ophthalmological evaluations, including Ocular Surface Disease Index (OSDI), tear break-up time (TBUT), ocular surface staining (OSS), Schirmer test, and conjunctival impression cytology (CIC), were performed. Results: The mean participant age was 23.4±5.3 years in the keratoconus group and 24.9±6.0 years in the control group. In the keratoconus group, the mean OSDI and OSS scores were statistically significantly higher than those of the controls, and the Schirmer and TBUT results were statistically significantly lower (all p<0.001). The severity of keratoconus was positively correlated with the CIC grade (r=0.292; p=0.004). Conclusion: Keratoconus results in deterioration of the ocular surface, including CIC and tear function parameters. The grade of keratoconus appears to be associated with conjunctival cytologic changes.
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    Safety and Efficacy of Corneal Crosslinking Treatment in Children with Keratoconus
    (2021) Özcan, Deniz Özarslan; Özcan, Sait Coşkun
    Background: To evaluate the safety and efficacy of corneal crosslinking (CXL) treatment in children with keratoconus. Materials and Methods: A total of 45 eyes of 34 children with progressive keratoconus were included in this study. CXL was performed according to the conventional method. Manifest refraction, uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), corneal topography values, and endothelial cell density (ECD) were evaluated at baseline and 24- month follow-up. Results: The mean age of the patients was 14.6±3.5 years. The mean spherical equivalent readings were statistically significantly decreased at 24 months (p=0.016). There was a significant improvement in the mean UDVA and CDVA at 24 months (p=0.002, p=0.006, respectively). The mean K1 and K2 were statistically significantly reduced at 24 months postoperatively (p=0.004, p=0.006, respectively). There was no significant alteration in ECD at any follow-up examination. No significant sight-threatening complications were observed. Conclusions: The CXL procedure seem to be safe and effective in stabilizing keratoconus progression in children within a follow-up of 24 months.