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Guideline
. 2015 Apr;34(4):359-69.
doi: 10.1097/ICO.0000000000000408.

Global consensus on keratoconus and ectatic diseases

José A P Gomes  1 , Donald Tan, Christopher J Rapuano, Michael W Belin, Renato Ambrósio Jr, José L Guell, François Malecaze, Kohji Nishida, Virender S Sangwan; Group of Panelists for the Global Delphi Panel of Keratoconus and Ectatic Diseases
Affiliations
Guideline

Global consensus on keratoconus and ectatic diseases

José A P Gomes et al. Cornea. 2015 Apr.

Abstract

Background: Despite extensive knowledge regarding the diagnosis and management of keratoconus and ectatic corneal diseases, many controversies still exist. For that reason, there is a need for current guidelines for the diagnosis and management of these conditions.

Purpose: This project aimed to reach consensus of ophthalmology experts from around the world regarding keratoconus and ectatic diseases, focusing on their definition, concepts, clinical management, and surgical treatments.

Methods: The Delphi method was followed with 3 questionnaire rounds and was complemented with a face-to-face meeting. Thirty-six panelists were involved and allocated to 1 of 3 panels: definition/diagnosis, nonsurgical management, or surgical treatment. The level of agreement considered for consensus was two thirds.

Results: Numerous agreements were generated in definitions, methods of diagnosing, and management of keratoconus and other ectatic diseases. Nonsurgical and surgical treatments for these conditions, including the use of corneal cross-linking and corneal transplantations, were presented in a stepwise approach. A flowchart describing a logical management sequence for keratoconus was created.

Conclusions: This project resulted in definitions, statements, and recommendations for the diagnosis and management of keratoconus and other ectatic diseases. It also provides an insight into the current worldwide treatment of these conditions.

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Comment in

  • Inflammation in Keratoconus.
    Galvis V, Tello A, Barrera R, Niño CA. Galvis V, et al. Cornea. 2015 Aug;34(8):e22-3. doi: 10.1097/ICO.0000000000000499. Cornea. 2015. PMID: 26075462 No abstract available.
  • Screening for Keratoconus and Related Ectatic Corneal Disorders.
    Randleman JB, Dupps WJ Jr, Santhiago MR, Rabinowitz YS, Koch DD, Stulting RD, Klyce SD. Randleman JB, et al. Cornea. 2015 Aug;34(8):e20-2. doi: 10.1097/ICO.0000000000000500. Cornea. 2015. PMID: 26075463 Free PMC article. No abstract available.
  • Reply: To PMID 25738235.
    Gomes JA, Rapuano CJ, Belin MW, Ambrósio R Jr; Group of Panelists for the Global Delphi Panel of Keratoconus and Ectatic Diseases. Gomes JA, et al. Cornea. 2015 Sep;34(9):e27-9. doi: 10.1097/ICO.0000000000000502. Cornea. 2015. PMID: 26165795 No abstract available.
  • Reply: To PMID 25738235.
    Gomes JA, Rapuano CJ, Belin MW, Ambrósio R Jr; Group of Panelists for the Global Delphi Panel of Keratoconus and Ectatic Diseases. Gomes JA, et al. Cornea. 2015 Sep;34(9):e27. doi: 10.1097/ICO.0000000000000501. Cornea. 2015. PMID: 26247279 No abstract available.
  • Screening for Keratoconus: Lack of a Scientific Base Regarding the Global Consensus?
    Saad A, Gatinel D. Saad A, et al. Cornea. 2015 Nov;34(11):e33-4. doi: 10.1097/ICO.0000000000000620. Cornea. 2015. PMID: 26382902 No abstract available.
  • Screening for Keratoconus and Related Ectatic Corneal Disorders: A Response.
    Steinberg J, Linke SJ. Steinberg J, et al. Cornea. 2015 Nov;34(11):e34-5. doi: 10.1097/ICO.0000000000000622. Cornea. 2015. PMID: 26382904 No abstract available.
  • Global Consensus on Keratoconus Diagnosis.
    Gomes JA, Rapuano CJ, Belin MW, Ambrósio R Jr; Group of Panelists for the Global Delphi Panel of Keratoconus and Ectatic Diseases. Gomes JA, et al. Cornea. 2015 Dec;34(12):e38-9. doi: 10.1097/ICO.0000000000000623. Cornea. 2015. PMID: 26426335 No abstract available.

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