Clinical status of patients diagnosed with keratoconus in a high complexity hospital in the Buenos Aires suburbs
DOI:
https://doi.org/10.70313/2718.7446.v15.n04.191Keywords:
keratoconus, epidemiology, crosslinking, intrastromal corneal ring-segmentsAbstract
Objective: To evaluate the clinical situation of patients diagnosed with keratoconus in a high complexity hospital in the Buenos Aires suburbs and their main therapeutic indications at the time of consultation.
Methods: A retrospective study was performed using data recorded in the medical records of all patients with a diagnosis of keratoconus evaluated during the period January 2019-February 2020.
Results: A total of 71 patients were included (142 eyes). The median age was 29 year. 14% of patients (7/51) had legal blindness. 30% of the patients (21/71) had undergone corneal transplant in at least one eye. Excluding transplanted eyes (n:22) 33% of the eyes had grade 1-2, 30% grade 3 and 37% grade 4 of Amsler Classification. Contact lens tolerance 45/120 (37%), with visual acuity equal or greater than 20/50 (53%). We found leukomas/hydrops in 14/120 (12%) of the eyes. The most frequent topographic patterns were “nipple”and “croissant” with 30% and 21% respectively. 37% of the eyes had pachymetry under 400 microns. Among those who had not been transplanted, 26% of the eyes (31/120) had indication of keratoplasty, 12% (14/120) for crosslinking and 40/120 eyes could have intrastromal rings implantation.
Conclusion: Most of the patients evaluated were younger than 30 years old, and presented with advanced degrees of keratoconus (G3-G4). 26% had an indication for corneal transplantation. Despite this, a significant percentage of patients could benefit from crosslinking to slow progression and/or intrastromal rings to improve visual acuity, which would reduce the need for transplantation with its implications.
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References
Rabinowitz YS. Keratoconus. Surv Ophthalmol 1998; 42: 297-319.
Krachmer JH, Feder RS, Belin MW. Keratoconus and related noninflammatory corneal thinning disorders. Surv Ophthalmol 1984; 28: 293-322.
Santodomingo-Rubido J, Carracedo G, Suzaki A et al. Keratoconus: an updated review. Cont Lens Anterior Eye 2022; 45: 101559.
Kennedy RH, Bourne WM, Dyer JA. A 48-year clinical and epidemiologic study of keratoconus. Am J Ophthalmol 1986; 101: 267-273.
Gokhale NS. Epidemiology of keratoconus. Indian J Ophthalmol 2013; 61: 382-383.
Davidson AE, Hayes S, Hardcastle AJ, Tuft SJ. The pathogenesis of keratoconus. Eye (Lond) 2014; 28: 189-195.
Millodot M, Ortenberg I, Lahav-Yacouel K, Behrman S. Effect of ageing on keratoconic corneas. J Optom 2016; 9: 72-77.
Saad S, Saad R, Jouve L et al. Corneal crosslinking in keratoconus management. J Fr Ophtalmol 2020; 43: 1078-1095.
Gomes JAP, Tan D, Group of Panelists for the Global Delphi Panel of Keratoconus and Ectatic Diseases et al. Global consensus on keratoconus and ectatic diseases. Cornea 2015; 34: 359-369.
Andreanos KD, Hashemi K, Petrelli M et al. Keratoconus treatment algorithm. Ophthalmol Ther 2017; 6: 245-262.
Albertazzi R, Blanco T. Génesis del queratocono, el “neuromisterio” mejor guardado: una visión neuroquímica y neurodegenerativa. Oftalmol Clin Exp 2020; 13: 173-188.
Hashemi H, Heydarian S, Hooshmand E et al. The prevalence and risk factors for keratoconus: a systematic review and meta-analysis. Cornea 2020; 39: 263-270.
Ortiz-Toquero S, Rodriguez G, Martin R. Clinical guidelines for the management of keratoconus patients with gas permeable contact lenses based on expert consensus and available evidence. Curr Opin Ophthalmol 2021; 32(Suppl 2): S1-S11.
Lucas SEM, Burdon KP. Genetic and environmental risk factors for keratoconus. Annu Rev Vis Sci 2020; 6: 25-46.
Wollensak G, Spoerl E, Seiler T. Riboflavin/ultraviolet-a-induced collagen crosslinking for the treatment of keratoconus. Am J Ophthalmol 2003; 135: 620-627.
Greenstein SA, Hersh PS. Corneal crosslinking for progressive keratoconus and corneal ectasia: summary of US multicenter and subgroup clinical trials. Transl Vis Sci Technol 2021; 10: 13.
Hwang S, Chung TY, Han J et al. Corneal transplantation for keratoconus in South Korea. Sci Rep 2021; 11: 12580.
Kasbekar SA, Jones MNA, Ocular Tissue Advisory Group (audit study 15) et al. Corneal transplant surgery for keratoconus and the effect of surgeon experience on deep anterior lamellar keratoplasty outcomes. Am J Ophthalmol 2014; 158: 1239-1246.
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