Effect Of Body Mass Index On Incidence Of Keratoconus And Corneal Structural Parameters

Published 2026 - 44th Congress of the ESCRS

Reference: FP18.06 | Type: Free paper | DOI: 10.82333/4w0d-jt71

Authors: Ms Zahra Ashena* ¹ , Dr Ayadul Islam ¹ , Dr Lucy Fox ¹ , Mohammad Saleki ¹ , Dr Wessam Mina ¹ , Dr Periklis Giannakis ² , Dr Vanessa Otti ¹

¹Ophthalmology,BHRUT,London,United Kingdom, ²Faculty of Medicine and Dentistry,QMUL,London,United Kingdom

Purpose

Few studies have investigated any potential correlation between body mass index (BMI) and the development of keratoconus. This research specifically aims to determine whether a higher BMI is associated with an increased incidence of keratoconus and to evaluate the impact of body mass index on specific corneal tomographic features, including maximum keratometry (Kmax), corneal astigmatism, and pachymetry. By examining these relationships, the study seeks to identify whether BMI serves as a relevant clinical indicator for disease occurrence and severity.

Setting

This is a prospective case-control study conducted at Queen’s Hospital, Barking, Havering and Redbridge NHS Trust, London, UK, between 2023 and 2025.

Methods

Participants were recruited from composmentis adults aged 18 to 45 attending the corneal clinic. The study population comprised 142 patients, with a control group of 56 individuals without keratoconus. Body weight and height were measured, and BMI was subsequently calculated. Each participant underwent corneal tomography using the Pentacam device. For all participants, Kmax, corneal astigmatism, mean keratometry (Kmean), and thinnest pachymetry were recorded. To investigate the relationship between BMI and the incidence and severity of keratoconus, statistical analyses using linear and logistic regression models were performed, both with and without adjustments for age, gender and ethnicity.

Results

In unadjusted logistic regression analysis, BMI was not significantly associated with the incidence of keratoconus (OR 1.024, 95% CI 1.004-1.059, p = 0.153). However, after adjustment for age, gender, and ethnicity, BMI was independently associated with increased odds of keratoconus (adjusted OR 1.044 per kg/m² increase, 95% CI 1.008-1.083, p = 0.0177). No significant association was observed in adjusted or unadjusted analysis between BMI and Kmax (p = 0.8 and 0.6, respectively), Kmean (p = 0.9 and 0.8, respectively), corneal astigmatism (p = 0.6 and 0.1, respectively), and thinnest pachymetry (p = 0.3 and 0.5, respectively).

Conclusions

Body Mass Index (BMI) was independently correlated with the development of keratoconus; however, it was not correlated with corneal curvature or thickness parameters. It was observed that for each 1 kg/m² increase in BMI, the odds of keratoconus rose by approximately 4.4% after adjusting for demographic covariates. This indicates that a higher BMI may be linked to the occurrence of the disease rather than its severity or corneal structural features. Since these are preliminary results, recruitment for this study is still ongoing to include more patients and controls.