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Global Consensus on Keratoconus and Ectatic Diseases-Edition 2.

José A P Gomes1,2, Farhad Hafezi3,4, Renato Ambrósio1,5,6

  • 1Department of Ophthalmology and Visual Sciences, Escola Paulista de Medicina/Universidade Federal de São Paulo (EPM/UNIFESP), São Paulo, Brazil.

Cornea
|June 2, 2026
PubMed
Summary

This updated global consensus revises definitions and management strategies for keratoconus and ectatic corneal diseases. It incorporates new technologies and broader international expert input for improved diagnosis and treatment.

Keywords:
consensuscorneal cross-linkingcorneal ectasiacorneal transplantationintraocular lenseskeratoconus

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Area of Science:

  • Ophthalmology
  • Corneal Surgery
  • Refractive Surgery

Background:

  • The first Global Consensus on Keratoconus and Ectatic Diseases was established ten years ago.
  • Advances in technology and surgical techniques necessitate an update.

Purpose of the Study:

  • To establish an updated global consensus on keratoconus and ectatic corneal diseases.
  • To define, diagnose, stage, and manage these conditions.
  • To integrate expertise from international corneal and refractive surgeons.

Main Methods:

  • Utilized the Delphi method with 4 rounds of questionnaires and a face-to-face meeting.
  • 128 ophthalmologists participated across 7 specialized panels.
  • Consensus defined as at least two-thirds agreement.

Main Results:

  • Significant agreement reached on definitions, diagnostic criteria, and management strategies.
  • A comprehensive approach to both nonsurgical and surgical treatments was outlined.
  • Major agreements and disagreements are detailed across subcommittees.

Conclusions:

  • This consensus provides revised definitions, expert statements, and recommendations.
  • Broader participation from international ophthalmic societies enhances global clinical perspective.
  • Offers updated guidance for diagnosing and managing keratoconus and ectatic corneal diseases.