Clinical management of keratoconus. A multicenter analysis

Area of Science:

• Ophthalmology
• Corneal Surgery
• Refractive Error Management

Background:

• Keratoconus is a progressive corneal ectasia leading to irregular astigmatism and visual impairment.
• Management strategies range from conservative measures to surgical interventions.
• Understanding outcomes and risk factors is crucial for optimal patient care.

Purpose of the Study:

• To retrospectively analyze the clinical management and outcomes of patients with keratoconus.
• To compare the effectiveness of nonsurgical, penetrating keratoplasty (PK), and epikeratoplasty interventions.
• To identify baseline predictors for surgical intervention in keratoconus.

Main Methods:

• Retrospective analysis of 746 eyes from 417 keratoconus patients (1984-1988).
• Categorization into nonsurgical (contact lenses/spectacles), penetrating keratoplasty (PK), and epikeratoplasty groups.
• Comparison of visual acuity, keratometry, and corneal cylinder before and after treatment.

Main Results:

• 74% of eyes were managed nonsurgically with improved visual acuity (20/30 to 20/25).
• PK and epikeratoplasty groups showed significant visual acuity gains (20/70 to 20/25 and 20/40 to 20/30, respectively) and reduced keratometry.
• Poor baseline visual acuity, high keratometry, and contact lens history predicted the need for PK.

Conclusions:

• Nonsurgical management remains the predominant approach for most keratoconus patients.
• Both PK and epikeratoplasty significantly improve visual outcomes in selected cases.
• Identifying risk factors aids in guiding surgical decisions for keratoconus management.