ESCRS - FP18.12 - A Systematic Review Of “Progressive Keratoconus” Definitions

A Systematic Review Of “Progressive Keratoconus” Definitions

Published 2023 - 41st Congress of the ESCRS

Reference: FP18.12 | Type: Free paper | DOI: 10.82333/e7mf-en15

Authors: Maria A. Henriquez 1 , Carolina Larco* 1 , Rolando Rojas 1 , Luis Izquierdo Jr 1

1Research Department,Oftalmosalud Institute of Eyes,Lima,Peru

Purpose

To evaluate the consistency and agreement among the different definitions of progressive keratoconus (P-KC) in the literature.

Setting

Research Department at Ofttalmosalud, Instituto de Ojos, Lima, Peru.

Methods

This prospective, systematic literature review aimed to identify the definitions used for progressive keratoconus in the published articles. A comprehensive search was conducted across Cochrane Library, Pubmed, Taylor&Francis, Web of Science, and others. Two independent reviewers assessed articles for eligibility, and articles that met inclusion criteria were selected for data extraction. The inclusion criteria for articles were articles from January 2018 to December 2022 having treated progressive keratoconus and containing the definition of “progressive keratoconus” or “keratoconus progression” and a sample size greater than ten eyes. The quality of the publications was assessed using the standard quality indices adapted from Deeks 2003.
 

Results

The initial search included 267 articles. Seventy-five studies comprising 3652 patients were selected for analysis. The definition for P-KC included data from keratometry in 100% of the articles, and data from refraction and pachymetric maps in 48% (36/75) and 33.3% (25/75) of the articles, respectively. The most frequent criterion used to define P-KC was maximum keratometry (Kmax), used in 72% (54/75) of the articles. 86.5% (60/75) of the articles employed Scheimpflug imaging analysis to assess progression. 80% of the articles included a follow-up time for progression, with a Mean of 12.23 ± 5.89 (range 2-36 months). Data from posterior cornea was used for definition in only 8% (6/75) of the studies.

Conclusions

This study demonstrated the lack of unified criteria for defining “progression” in KC. According to this review, the most common criteria used for progression are related to keratometry, refraction, and corneal pachymetry.