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Optimized decision-tree for keratoconus management: from advance ocular analysis to penetrating keratoplasty

Poster Details

First Author: F.Faria-Correia PORTUGAL

Co Author(s):    I. Ramos   T. Monteiro   B. Lopes   B. Valbon   F. Vaz   R. Ambrósio Jr.

Abstract Details


Keratoconus (KC) is one of the leading indications for corneal transplant worldwide. Currently, there is a shift from the gold-standard penetrating keratoplasty to other less-invasive surgical treatment options. Based on the current literature and clinical cases presentation, we describe our optimized decision-tree for KC management.


Ophthalmology Department, Hospital de Braga, Braga - Portugal; Instituto de Olhos Renato Ambrósio, Rio de Janeiro - Brazil; Rio de Janeiro Corneal Tomography and Biomechanics Study Group


Retrospective case series. Five KC cases with different grades of severity were managed based on the decision-tree. Relevant literature was reviewed to establish the more suitable management approach for KC cases and to define the preoperative factors for good visual outcomes.


In Case 1, a conservative approach with contact lenses was selected, after wavefront-assisted manifest refraction and ocular surface optimization. Cases 2 to 5 represent different grades of KC with progressive disease and/or contact lens intolerance. We selected different surgical treatment modalities (alone or combined) based on the advanced ocular analysis. During the postoperative period, the patients achieved a best-corrected visual acuity superior to 20/30 with less complains regarding the optical quality.


This optimized decision-tree was found very useful for the plan of treatment strategy of different stages of KC. The main therapeutic goals were achieved: stop progression of the disease, visual rehabilitation and avoid the need of a corneal transplant. FINANCIAL INTEREST: One of more of the authors... receives nonNONEmonetary benefits from a company producing, developing or supplying the product or procedure presented.

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