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Three Different Protocols of Corneal Collagen Crosslinking in Keratoconus: Conventional, Accelerated and Iontophoresis
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Keratoconus: The ABCD Grading System.

M W Belin1, J K Duncan2

  • 1Ophthalmology & Vision Science, University of Arizona, Marana, Arizona, United States.

Klinische Monatsblatter Fur Augenheilkunde
|January 21, 2016
PubMed
Summary
This summary is machine-generated.

A new keratoconus staging system uses corneal curvature and thickness to better classify disease progression. This system, incorporating anterior and posterior data, offers a more accurate reflection of anatomical changes in keratoconus patients.

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Area of Science:

  • Ophthalmology
  • Corneal Imaging
  • Refractive Surgery

Background:

  • Keratoconus is a progressive corneal ectasia leading to vision impairment.
  • Current classification systems may not fully capture the anatomical and functional changes.
  • Tomographic data offers advanced insights into corneal structure.

Purpose of the Study:

  • To introduce a novel keratoconus classification and staging system.
  • To integrate current tomographic data for improved accuracy.
  • To better represent the anatomical and functional alterations in keratoconus.

Main Methods:

  • Reanalysis of a normative database to derive anterior and posterior average radii of curvature (ARC and PRC).
  • Measurements were taken from a 3.0 mm optical zone centered on the thinnest corneal point.
  • A new classification was constructed using ARC, PRC, thinnest pachymetry, and distance visual acuity, compared against the Amsler-Krumeich (AK) Classification.

Main Results:

  • Analysis included 672 eyes from 336 patients.
  • Mean ARC: 7.65 ± 0.236 mm; Mean PRC: 6.26 ± 0.214 mm; Mean thinnest pachymetry: 534.2 ± 30.36 µm.
  • The proposed system showed close correlation with AK stages 1-4 based on anterior curvature, with significant standard deviation differences for pachymetric values in stages 2 and 3.

Conclusions:

  • A new 5-stage (0-4) keratoconus staging system is proposed.
  • This system integrates anterior/posterior curvature, thinnest pachymetry, and visual acuity.
  • It offers a more anatomically representative classification of keratoconus compared to existing methods.