Prevailing practice patterns in keratoconus among Indian ophthalmologists

Area of Science:

• Ophthalmology
• Corneal Diseases
• Medical Practice Patterns

Background:

• Keratoconus (KC) management has advanced rapidly, yet no standard care exists.
• Understanding current diagnostic and treatment practices among Indian ophthalmologists is crucial.

Purpose of the Study:

• To evaluate the prevailing practice patterns in keratoconus diagnosis and treatment among Indian ophthalmologists.
• To identify common diagnostic modalities and treatment decisions for keratoconus.

Main Methods:

• A cross-sectional, survey-based study was conducted using an online questionnaire.
• 273 ophthalmologists provided data on their experience, training, diagnostic tools, and treatment strategies for KC.

Main Results:

• Pentacam was the most frequent topographer used. The minimum pachymetry for collagen crosslinking (CXL) was typically 400μ.
• Over half of respondents did not perform photorefractive keratectomy (PRK) or intracorneal ring segment (ICRS) implantation. Accelerated CXL protocols were most common.
• For patients unsuitable for CXL, contact lens trials were most advised, followed by keratoplasty, with corneal scarring being the primary indication for the latter.

Conclusions:

• Topography is the primary diagnostic tool for keratoconus, with OCT and epithelial mapping gaining importance for early detection.
• There is variability in the adoption of advanced procedures like ICRS and PRK.
• Contact lens trials remain the most frequent recommendation for patients ineligible for CXL, preceding keratoplasty.