The prevalence of refractive errors among patients with keratoconus attending Damascus hospital, Syria: a...

Keratoconus (KC) is a progressive ectatic corneal disease characterized by corneal thinning and cone-like protrusion, leading to significant refractive errors. Despite its global impact, local data for the Syrian population remains scarce. This study aimed to investigate refractive error patterns, prevalence, and disease grading among a sample of Syrian patients with KC.

This prospective cross-sectional study evaluated 173 eyes from 93 patients at Damascus Hospital. Corneal Tomography was performed using the Pentacam Scheimpflug system. Refractive status was determined via subjective refraction, and KC severity was graded using the Buxton keratometric classification. Statistical analysis included Chi-square tests and Pearson correlations.

The mean age of participants was 29.7 ± 10.9 years, with most patients (34.4%) aged 19-30 years. Bilateral involvement was observed in 92.5% of patients. Mild and moderate disease were the most frequent grades, accounting for 45.1% and 43.9% of eyes, respectively. A significant association between KC grading and gender was identified (P = 0.04), whereas no significant association was found between grading and age. Oblique compound myopic astigmatism was the most prevalent refractive error (25.4%). Kmax showed a strong positive correlation with absolute spherical equivalent (r = 0.669, P < 0.001), whereas corneal thickness at the thinnest location showed a weak negative correlation (r = -0.393, P < 0.001).

The clinical profile of KC in Syrian patients is comparable to reports from other regional and global populations, manifesting as bilateral mild-to-moderate disease in young adults, with compound myopic astigmatism as the hallmark refractive error. Future research should prioritize multicenter genetic and environmental studies within the Syrian population to optimize disease management strategies and early detection.