Preferred Practice Patterns For Keratoconus: An E‑Survey Among Saudia Cornea Specialists

This study aimed to report practice patterns in the management of keratoconus in Saudi Arabia

The management of keratoconus has vastly evolved in
the past two decades. Several novel diagnostic tools such
as the Orbscan II, Scheimpflug imaging‑based devices
such as the Pentacam, anterior segment optical coherence
tomography (AS‑OCT), Ocular Response Analyzer, and
wavefront aberrometers were introduced. These devices can
better characterize the pathological changes in the cornea,
leading to an early diagnosis

An e‑survey was conducted among members of the Cornea Society of Saudi Arabia to assess preferred practice patterns for keratoconus

Of the 465 members, 160 (36.5%) completed the survey. About
83.4% worked in private eye care facilities and 68.1% in cities. Of all the respondents, 87.5% had access to a Scheimpflug‑based device or an Orbscan II®; 64.4% of the respondents dispensed scleral contact lenses; 87.7% of the respondents performed corneal cross‑linking (CXL); and 69.1% of the respondents performed deep anterior lamellar keratoplasty (DALK). The diagnostic criteria for keratoconus followed by the majority of the respondents (52.1%)
were increase in corneal curvature, elevation, and thickness. An increase in keratometry values greater than 0.5 or 1.0D in a 6‑month to 1‑year period was considered the most favored criterion for keratoconus progression. 

While keratoconus management in Saudi Arabia is comparable to other developed healthcare systems, the concentration of trained corneal surgeons in cities and private eyecare facilities may lead to less equitable distribution of treatment across the country.