First results of the treatment of limbal-scleral staphylomas in children. Clinical cases
https://doi.org/10.21516/2072-0076-2025-18-3-127-132
Abstract
Limbal-scleral staphylomas in children are a serious problem in pediatric ophthalmology, as they lead to severe consequences, including anatomical death of the eye.
The purpose of the work is to evaluate the results of a new combined method for treating limbal-scleral staphylomas in children using and local ultraviolet (UVA) crosslinking of scleral collagen (CSC) and transscleral diode laser cyclophotocoagulation (TDLC).
Material and methods. CSC was performed for 2 children aged 12 and 15 with limbal-scleral staphylomas after TDLC. Biomicroscopy, optical coherence tomography of the anterior segment of the eye and determination of the acoustic density of the sclera were used for dynamic observation of patients. The procedure of local UVA crosslinking of limbal staphylomas of the sclera was carried out using a new device for local ultraviolet crosslinking based on the permission of the Ethics Committee of the Helmholtz National Medical Research Center of Eye Diseases. The CSC procedure time was 5 min with an exposure power of 2.5 mW/cm.
Results. The use of TDLC and five local CLSC procedures combined with instillations of 0.1% riboflavin solution provided an increase in the thickness and acoustic density of the sclera, as well as a decrease in the area and height of the limbal staphyloma.
Conclusion. The first results of treating scleral staphylomas in children using a new device for local UVA crosslinking showed its high therapeutic efficacy and the feasibility of further research to advance this method into clinical practice.
About the Authors
A. V. Pleskova
Helmholtz National Medical Research Center of Eye Diseases
Russian Federation
Russian Federation
Alla V. Pleskova — Dr. of Med. Sci., senior researcher, department of children’s eye pathology
14/19, Sadovaya-Chernogryazskaya St., Moscow, 105062
L. A. Katargina
Helmholtz National Medical Research Center of Eye Diseases
Russian Federation
Russian Federation
Lyudmila A. Katargina — Dr. of Med. Sci., professor, deputy director, head of department of children’s eye pathology
14/19, Sadovaya-Chernogryazskaya St., Moscow, 105062
E. N. Iomdina
Helmholtz National Medical Research Center of Eye Diseases
Russian Federation
Russian Federation
Elena N. Iomdina — Dr. of Biol. Sci., professor, principal researcher of department of refraction pathology, binocular vision and ophthalmoergonomics
14/19, Sadovaya-Chernogryazskaya St., Moscow, 105062
A. Yu. Panova
Helmholtz National Medical Research Center of Eye Diseases
Russian Federation
Russian Federation
Anna Yu. Panova — Cand. of Med. Sci., researcher, department of children’s eye pathology
14/19, Sadovaya-Chernogryazskaya St., Moscow, 105062
V. R. Getadaryan
Helmholtz National Medical Research Center of Eye Diseases
Russian Federation
Russian Federation
Vostan R. Getadaryan — Cand. of Med. Sci., researcher, department of children’s eye pathology
14/19, Sadovaya-Chernogryazskaya St., Moscow, 105062
References
1. Muldashev E.R., Kornilaeva G.G. Staphylomas of the sclera. Ufa, 2000 (In Russ.).
2. Oh JH, Kim JC. Repair of scleromalacia using preserved scleral graft with amniotic membrane transplantation. Cornea. 2003; 22 (4): 288–93. doi: 10.1097/00003226-200305000-00002
3. Kim JT, Kim KW, Mun SK, Chun YS, Kim JC. Transplantation of autologous perichondrium with amniotic membrane for progressive scleral necrosis. Ocul Surf. 2019 Jul; 17 (3): 571–7. doi: 10.1016/j.jtos.2019.05.004
4. Kiseleva O.A., Sochalina N.Yu., Iomdina E.N., Antonova M.D., Shkurenko S.I. Method of surgical treatment of staphylomas or bedsores of the sclera of various etiologies. RU Patent 2279264 C2, 2006 (In Russ.).
5. Muldashev E.R., Kornilaeva G.G., Galimova V.U. Method of surgical treatment of extensive staphylomas of the sclera in secondary glaucoma. Patent RU 2187987 C2, 2002 (In Russ.).
6. Kornilaeva G.G., Kornilaeva M.P., Primov R.E., Volgareva E.A., Shangina O.R. Algorithm for selecting alloplant biomaterials for post-traumatic staphylomas. Medical Bulletin of Bashkortostan. 2021; 16, 4 (94): 19–22 (In Russ.).
7. Iomdina E.N., Daragan V.A., Ilyina I.E. Certain biomechanical properties and cross linking of the scleral shell of the eye in progressive myopia. In: Proc. of XIVth I.S.B. Congress on Biomechanics. Paris; 1993: 616–7.
8. Iomdina E.N. Biomechanical and biochemical disorders of the sclera in progressive myopia and methods of their correction. In: Avetisov S.E., Kashchenko T.P., Shamshinova A.M., eds. Visual functions and their correction in children. Moscow: Meditsina; 2005: 163–83 (In Russ.).
9. Wollensak G. Zwanzig Jahre Crosslinking-Behandlung. Ophthalmologie. 2022; 119: 872–3. https://doi.org/10.1007/s00347-022-01690-8
10. Bikbov M.M., Zainutdinova G.C., Usubov E.L., Lukianova E.E., Oganisyan K.C. Results of treatment of keratectasia by the corneal cross-linking method in children and teenagers. Fyodorov journal of ophthalmic surgery. 2015; (3): 74–8 (In Russ.)
11. Markova E.Yu., Kostenev S.V., Grigorieva A.G., Perfilyeva E.A. Modern trends in the treatment of keratoconus in children. Ophthalmology in Russia. 2017; 14 (3): 188–194 (In Russ.). https://doi.org/10.18008/1816-5095-2017-3-188-194
12. Pleskova A.V., Katargina L.A., Iomdina E.N., et al. First results of clinical application of ultraviolet crosslinking of corneal collagen in treatment of ulcerative lesions of the cornea and transplant in children. Ophthalmology in Russia. 2022; 19 (3): 692–8 (In Russ.). https://doi.org/10.18008/1816-5095-2022-3-692-698
13. Khandzhyan A.T., Iomdina E.N., Ivanova A.V., et al. Efficiency and safety of the Russian-made Keratolink device used to treat patients with stage I–II keratoconus and pellucid marginal corneal degeneration. Russian ophthalmological journal. 2024; 17 (3): 66–73 (In Russ.). https://doi.org/10.21516/2072-0076-2024-17-3-66-73
14. Iomdina E.N., Wollenzak G., Mukhamedyarov F., Salamatina O.B., Rudnev S.N. New opportunities for increasing the biomechanical stability of the sclera with progressive myopia. In: Ocular biomechanics 2004. Moscow; 2004: 63–7 (In Russ.).
15. Kasparova Evg.A., Yan Biao, Sobkova O.I. Clinical case: modified crosslinking in the treatment of advanced purulent corneal ulcer. Ophthalmology in Russia. 2017; 14 (3): 274–7 (In Russ.).
16. Seliverstova K.E., Iomdina E.N., Yani E.V. Efficiency and safety of the domestic device Keratolink for the treatment of patients with bacterial corneal ulcers. Ophthalmology in Russia. 2024; 21 (3): 502–8 (In Russ.). https://doi.org/10.18008/1816-5095-2024-3-502-508
17. Iomdina E.N., Tarutta E.P., Markosyan G.A., Papyan V.N., Milash S.V. Scleral collagen crosslinking as a promising direction of sclera-strengthening treatment of progressive myopia. Russian ophthalmological journal. 2024; 17 (2): 128–34 (In Russ.). https://doi.org/10.21516/2072-0076-2024-17-2-128-134
18. Dotan A, Kremer I, Livnat T, et al. Scleral cross-linking using riboflavin and ultraviolet-A radiation for prevention of progressive myopia in a rabbit model. Exp Eye Res. 2014; 127: 190–5. https://doi.org/10.1016/j.exer.2014.07.019
19. Liu S, Li S, Wang B, Lin X, et al. Scleral cross-linking using riboflavin uva irradiation for the prevention of myopia progression in a guinea pig model: Blocked axial extension and altered scleral microstructure. PLoS One. 2016 Nov 9; 11(11): e0165792. doi: 10.1371/journal.pone.0165792
Review
For citations:
Pleskova A.V., Katargina L.A., Iomdina E.N., Panova A.Yu., Getadaryan V.R. First results of the treatment of limbal-scleral staphylomas in children. Clinical cases. Russian Ophthalmological Journal. 2025;18(3):127-132. (In Russ.) https://doi.org/10.21516/2072-0076-2025-18-3-127-132
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