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Updated: Apr 15, 2026
07:29
Three Different Protocols of Corneal Collagen Crosslinking in Keratoconus: Conventional, Accelerated and Iontophoresis
Published on: November 12, 2015
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Natural History and Progression of Untreated Keratoconus: An Updated Systematic Review and Meta-Analysis
Tsung-Hsien Tsai1,2, Jui-Hung Hsu3, Chin-Ling Tsai4,5
1Department of Ophthalmology, Chang Gung Memorial Hospital, Keelung, Taiwan.
Current Eye Research
|April 14, 2026
Summary
Untreated keratoconus progresses over time, particularly in younger individuals with steeper corneas. Early detection and monitoring using advanced metrics are crucial for better risk assessment and timely intervention in keratoconus management.
Area of Science:
- Ophthalmology
- Corneal Diseases
- Vision Science
Background:
- Keratoconus is a progressive corneal ectasia leading to vision impairment.
- Understanding the natural history of untreated keratoconus is essential for effective management.
- Previous studies have limitations in follow-up duration and diagnostic parameters.
Purpose of the Study:
- To conduct an updated systematic review and meta-analysis on the natural history of untreated keratoconus.
- To incorporate advanced diagnostic parameters and extended follow-up periods into the analysis.
- To identify predictors of keratoconus progression.
Main Methods:
- Systematic search of PubMed, Embase, Web of Science, and Scopus databases.
- Inclusion of studies with ≥6 months follow-up of untreated keratoconus eyes.
- Meta-analysis using random-effects models and meta-regression for predictor analysis.
Main Results:
- Analysis of 92 studies with 30,342 eyes revealed progressive changes in keratometry (Kmax, Kmean) and corneal thickness.
- Significant deterioration observed beyond 12 months of follow-up.
- Younger age and higher baseline Kmean predicted faster Kmax progression.
Conclusions:
- Untreated keratoconus exhibits time-dependent progression.
- Baseline Kmean may be a more reliable predictor of progression than Kmax.
- A comprehensive monitoring approach is recommended for improved risk stratification and intervention in keratoconus patients.
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