Epidemiology of Keratoconus

Barbara, Ramez; Turnbull, Andrew M.J.; Hossain, Parwez; Anderson, David F.; Barbara, Adel

doi:10.1007/978-3-319-43881-8_3

Cited by 9 publications

(9 citation statements)

References 91 publications

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“…[3][4][5][6][7][8] Additionally, patients with DS are usually affected by collagen-related disorders, which may also explain the corneal changes that patients with DS frequently show. [9][10][11][12][13][14] Furthermore, it has been reported that patients with DS frequently rub their eyes, 11 which is a habit related to keratoconus development owing to the inflammation process and biomechanical alterations linked to eye rubbing habit. 11 Keratoconus is a corneal ectatic condition characterized by corneal thinning, gradual corneal protrusion, and progressive irregular astigmatism.…”

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confidence: 99%

“…10,11 The incidence may vary according to the geographic region, although there are also studies supporting the fact that the prevalence is higher in zones with higher ultraviolet exposure or with a combination of genetic and environmental factors. 12 Some authors have reported that the incidence of keratoconus in patients with DS may be between 10 and 300 times more frequent than in individuals without DS. 13,14 Therefore, the purpose of this study is to report the corneal morphologic characteristics in a large series of patients with DS, with special attention to detect corneal ectatic disorders and to compare it with a control group.…”

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confidence: 99%

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Corneal Morphologic Characteristics in Patients With Down Syndrome

et al. 2018

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IMPORTANCE Literature suggests corneal morphologic characteristics compatible with keratoconus are present in a high percentage of patients with Down syndrome (DS), suggesting the need to perform a detailed examination of the anterior segment to try to avoid serious visual impairment in this group of patients. OBJECTIVE To characterize the abnormal features of the cornea in patients with DS and compare these with a control group. DESIGN, SETTING, AND PARTICIPANTSMulticenter case-control study at Vissum Alicante, . The study included 321 eyes of 217 participants from 2 groups: 112 participants in the DS group and 105 healthy participants in the control group.INTERVENTIONS Patients were evaluated using Placido disc/Scheimpflug camera topographer (Sirius, CSO). Visual, refractive and anterior, and posterior corneal characteristics were assessed and compared in both groups.MAIN OUTCOMES AND MEASURES Keratoconus diagnosis. Incidence of corneal morphologic irregularities similar to keratoconus in patients with DS. RESULTSIn the DS group, mean (SD) age was 14.88 (15.76) years, 54 (48%) were women, 66 (59%) were white, and 46 (41%) were Arab. In the control group, mean (SD) age was 40.29 (14.66) years, 54 (51%) were women, and all were white. Clinical assessment of corneal topography showed that 71.3% (95% CI, 45.2-97.4) of patients in the DS group showed characteristics compatible with keratoconus. Differences were found in steepest keratometry of 47.35 diopters (D) in patients with DS vs 43.70 D in control individuals (difference, 3.65 D; 95% CI, 3.23-4.35 D; P <.001) and in corneal pachymetry of 503 μm in patients with DS vs 545 μm in control individuals (difference, 42 μm; 95% CI, 38.8-56.7 μm; P <.001).CONCLUSIONS AND RELEVANCE Patients with DS have steeper and thinner corneas and more corneal aberrations than those without genetic alterations and normal corneas. The findings suggest a detailed corneal study should be considered in such patients to detect keratoconus and implement treatment as appropriate to try to avoid serious visual impairment in this group of patients. JAMA Ophthalmol. 2018;136(9):971-978.

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confidence: 99%

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Corneal Morphologic Characteristics in Patients With Down Syndrome

et al. 2018

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“…PKP is a major surgery with high rate of anatomical success, S Pramanik et al report on extended long-term follow-up (FU), mean FU of 13.8 years (0.5-30.4) of PKP for KC among the 112 eyes of 84 patients, 7 eyes (6.3%) experienced graft failure. Recurrent keratoconus was confirmed clinically or histologically in 6 eyes (5.4%), with a mean time to recurrence of 17.9 years (11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27), graft survival rate of 85.4% and a rate of recurrent keratoconus of 11.7% at 25, 82 eyes (73.2%) had BSCVA of 20/40 or better. 4 RJ Olson reported on PKP for KC with a 3.5 years FU.…”

Section: Discussionmentioning

confidence: 99%

“…19 In a review on KC recurrence after PK and DALK for KC Barbara R et al report on a recurrence rate of 1.7 to 5.4%. 20 High keratometry values may represent an under-recognized 21 To summarize this literature review PKP is a major surgery which can cause complications such as rejection, glaucoma and cataract and even recurrence of the KC despite high anatomical success rate in the long-term FU there is high rate of astigmatism after PKP which necessitates the use of CL and other refractive procedures such as LASIK, PRK and relaxing incisions in order to reduce the astigmatism. DALK causes less complications but yields similar results in terms of VA.…”

Section: Discussionmentioning

confidence: 99%

“…Astigmatism remain the main drawback of PKP. Progressive astigmatism was recorded in a long-term FU of 20 years(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25) in eighty eyes were. The astigmatism was 4.05 ± 2.29 D 1 year after suture removal, 3.90 ± 2.28 D at year 3, 4.03 ± 2.49 D at year 5, 4.39 ± 2.48 D at year 7 followed by a progressive increase from 10 years after suture removal until the last FU (5.48 ± 3.11 D at year 10, 6.43 ± 4.11 D at year 15; 7.28 ± 4.21 D at year 20, and 7.25 ± 4.27 D at year 25.…”

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Intrastromal Corneal Ring Segment with and without Collagen Corneal Crosslinking vs Penetrating Keratoplasty for the Treatment of Keratoconus

2014

International Journal of Keratoconus and Ectatic Corneal Diseases

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Keratoconus (KC) is a noninflammatory progressive corneal degeneration that cause irregular astigmatism especially in moderate and advanced cases, the irregular astigmatism can not be corrected by glasses, contact lenses are the only optical way for improving the visual acuity (VA) in these patients. In this retrospective study, we shall present the results of eight patients suffering from KC who were treated by PKP in one eye (PKP group) and ICRS (ICRS group) with or without CXL in the second eye. All the ICRS surgeries, the CXL and the PRK were performed at the I Vision, Refractive Surgery and Keratoconus Treatment Center in Haifa, Israel, by the same surgeon (AB), the PKPs were performed elsewhere, because they were treated in our medical center after the PKP.

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