[Detection of keratoconus using wavefront analysis]

Area of Science:

• Ophthalmology
• Corneal Imaging
• Wavefront Aberrometry

Background:

• Keratoconus is a progressive corneal ectasia.
• Early detection is crucial for managing refractive surgery candidates.
• Wavefront analysis offers a detailed assessment of corneal topography.

Purpose of the Study:

• To evaluate the efficacy of wavefront analysis in identifying keratoconus.
• To differentiate between healthy, suspect, forme fruste, and early keratoconus.
• To assess the diagnostic value of specific corneal aberrations.

Main Methods:

• Prospective study (2008-2010) with 4 groups: healthy, suspect, forme fruste, and beginning keratoconus.
• Analysis of total and corneal aberrations using wavefront technology.
• Statistical comparison (Fisher, Student t-tests) and ROC curve analysis for diagnostic performance.

Main Results:

• Corneal coma (Z3), trefoil (Z3), and secondary astigmatism (Z4) distinguished healthy from suspect corneas.
• Corneal coma showed the highest discrimination (Youden=0.334, sensitivity=60.5%) between healthy and suspect groups.
• High-order aberrations were valuable for grading keratoconus severity and differentiating suspect from forme fruste stages.

Conclusions:

• Wavefront analysis aids in detecting keratoconus suspect, forme fruste, and early stages.
• Corneal aberrations are more discriminative than total aberrations.
• Combined with videotopography and pachymetry, wavefront analysis enhances refractive surgery consultations.