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Related Experiment Video

Updated: Jul 17, 2026

Three Different Protocols of Corneal Collagen Crosslinking in Keratoconus: Conventional, Accelerated and Iontophoresis
07:29

Three Different Protocols of Corneal Collagen Crosslinking in Keratoconus: Conventional, Accelerated and Iontophoresis

Published on: November 12, 2015

Unilateral keratoconus. Incidence and quantitative topographic analysis

D R Holland1, N Maeda, S B Hannush

  • 1Department of Ophthalmology, University of Texas Southwestern Medical Center at Dallas, USA.

Ophthalmology
|October 6, 1997
PubMed
Summary

Unilateral keratoconus is rare, with most cases eventually progressing to affect both eyes. Quantitative topography measures show no difference between unilateral and bilateral keratoconus, advising caution with refractive surgery on the unaffected eye.

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Area of Science:

  • Ophthalmology
  • Corneal topography
  • Keratoconus research

Background:

  • Keratoconus is a progressive corneal ectasia.
  • Unilateral presentation of keratoconus is uncommon.
  • Understanding disease progression is crucial for patient management.

Purpose of the Study:

  • To determine the incidence of unilateral keratoconus.
  • To compare corneal topography metrics between unilateral and bilateral keratoconus.
  • To inform clinical decision-making regarding refractive surgery.

Main Methods:

  • Retrospective analysis of 164 patients with moderate-to-advanced keratoconus.
  • Corneal topography evaluated in both eyes.
  • Comparison of Keratoconus Prediction Index (KPI), Surface Asymmetry Index (SAI), and Surface Regularity Index (SRI).

Main Results:

  • Only 1.83% of patients presented with unilateral keratoconus.
  • No significant differences in KPI, SAI, or SRI between unilateral and bilateral cases.
  • One patient initially diagnosed with unilateral keratoconus developed contralateral signs over 4 years.

Conclusions:

  • The incidence of clinically diagnosed unilateral keratoconus is very low.
  • Quantitative topographic descriptors are similar in unilateral and bilateral keratoconus.
  • Contralateral eyes of unilateral keratoconus patients may develop the condition over time, cautioning against refractive surgery.