ESCRS - P099 - CLINICAL PRESENTATION OF PROGRESSIVE KERATOCONUS AND TREATMENT OUTCOMES FOR CORNEAL CROSSLINKING BY RACE

CLINICAL PRESENTATION OF PROGRESSIVE KERATOCONUS AND TREATMENT OUTCOMES FOR CORNEAL CROSSLINKING BY RACE

Published 2023 - 27th ESCRS Winter Meeting

Reference: P099 | Type: Free Paper Submission | DOI: 10.82333/0qnf-jw68

Authors: Philip Dockery* 1 , Eric Kim 2 , John Parker 3 , Jack Parker 4

1Parker Cornea,Birmingham,United States;Jones Eye Institute at University of Arkansas for Medical Sciences,Little Rock,United States, 2Wills Eye Hospital,Philadelphia,United States, 3Parker Cornea,Birmingham,United States, 4Parker Cornea,Birmingham,United States;Netherlands Institute for Innovative Ocular Sugery USA - NIIOS USA,San Diego,United States

Purpose

To assess the difference in clinical presentation of keratoconus and treatment outcomes for corneal crosslinking by race.

Setting

A single center tertiary referral cornea service.

Methods

A retrospective analysis of 508 eyes in 347 patients with progressive keratoconus were stratified by race – White (n=257 eyes) vs Black (n=251 eyes) – and treated with corneal crosslinking then were evaluated for visual acuity, tomography, and disease progression status.

Results

Compared to Whites, Blacks were more likely to report eye rubbing (p=0.04) and have keratoconus requiring bilateral crosslinking (p=0.04). At initial presentation, Blacks were more likely to have more advanced keratoconus: thinner central corneal thickness (462 μm vs 488 μm, p<0.001) and higher keratometry, including K1 (50.5 D vs 46.5 D, p<0.001), K2 (55.1 D vs. 50.4 D, p<0.001), and Kmax (63.8 D vs 57.8 D, p<0.001). When accounting for non-racial demographic differences, Blacks were at increased risk of continued disease progression requiring repeat crosslinking (RR=4.5, p=0.03), but when also accounting for variation in disease severity, there was no difference in rate of progression (p=0.29).

Conclusion

Black patients are more likely to initially present with more advanced keratoconus compared to their White counterparts, leading to an increased risk of continued progression following crosslinking, which may be attributable to delayed or reduced access to care. However, when controlling for stage of disease the outcomes are no different by race.