Topographic Keratoconus Incidence Diagnosed In Routine Consecutive Cataract Procedures In Greece: A Consecutive Case Series In 1250 Cases Over 5 Years.

Scheimplug tomography has been for many years an integral part of our pre-operative assessment and measurement in cataract extraction. We retrospectively reviewed the incidence of topographic keratoconus and also keratoconus suspicion in our routine cataract surgery population over 5 years

The Laservision Clinical and Research Institute, Athens, Greece

in 1250 consecutive cataract surgery cases by one surgeon (AJK) in otherwise naïve eyes, accounting for years 2017 to 2021 we retrospectively evaluated by 5 different experienced evaluators (2 ophthalmic surgeons and 3 optometrists) the topographic incidence of keratoconus as classified by the Pentcam HR (stages 1 to 4) as well as keratoconus suspicion based on irregular pachymetry distribution, astigmatism truncation and/or irregularity. We formed 4 groups: A: keratoconus, B: suspicious for keratoconus, C: regular corneas and D: irregular corneas not keratoonus-related.

Based on corneal topographic data the cases were classified as: 138 or 11% were included in group A, 314 or 26% in group B, 725 0r 58% in group C and final 6 or 5% in group D respectively. There was no disagreement between the 5 evaluators for any of the cases in group A, C and D, and little variance among them for cases included in group B (less than 5%).

The incidence of keratoconus and corneas suspicious for keratoconus in Greece appear to be greatly higher than the respective reports from other regions: one in ten Greeks appears to have topographic keratconus-most not diagnosed even by the age of cataract surgery- and almost one in four may have suspicious corneal imaging for keratoconus. The implications of these data are great to promote routine screening for the disease among Greeks, especially in puberty and careful screening when laser vision correction is considered.