Clinical profile and risk factors for keratoplasty and development of hydrops in north Indian patients with keratoconus

Abstract

Purpose: To review the profile of Indian patients with keratoconus and evaluate risk factors for keratoplasty and development of hydrops.

Methods: In this prospective observational study, 120 consecutive patients with bilateral or unilateral keratoconus presenting to the cornea services of a large, tertiary care ophthalmic center were evaluated. A detailed history including information about the age at onset of symptoms, nature of ocular complaints, and so on was taken. Investigations included visual acuity, slit-lamp examination, keratometry, pachymetry, and videokeratography.

Results: There were 76 males and 44 females (mean age at presentation was 20.07 +/- 6.4 years). Five percent families revealed a positive family history. Earlier age at onset (P = 0.002) and eye rubbing (P = 0.02) were found significantly associated with increased risk for surgery. Eyes undergoing surgery had steeper corneas, lower best-corrected visual acuity, corneal scarring, and vernal keratoconjunctivitis were significant risk factors (P values: 0.001, 0.0001, and 0.04, respectively). Hydrops represents a significant independent risk factor for surgery (P = 0.0001). Patients with younger age at onset (P value 0.01), history of eye rubbing (P value 0.02), and atopy (P value 0.01) had higher risk for developing corneal hydrops.

Conclusion: This knowledge of risk factors should enable clinicians and patients to make more informed decisions regarding the management of keratoconus.