Clinical Profile and Risk Factors for Keratoplasty and Development of Hydrops in North Indian Patients With Keratoconus

Abstract

To review the profile of Indian patients with keratoconus and evaluate risk factors for keratoplasty and development of hydrops. In this prospective observational study, 120 consecutive patients with bilateral or unilateral keratoconus presenting to the cornea services of a large, tertiary care ophthalmic center were evaluated. A detailed history including information about the age at onset of symptoms, nature of ocular complaints, and so on was taken. Investigations included visual acuity, slit-lamp examination, keratometry, pachymetry, and videokeratography. There were 76 males and 44 females (mean age at presentation was 20.07 +/- 6.4 years). Five percent families revealed a positive family history. Earlier age at onset (P = 0.002) and eye rubbing (P = 0.02) were found significantly associated with increased risk for surgery. Eyes undergoing surgery had steeper corneas, lower best-corrected visual acuity, corneal scarring, and vernal keratoconjunctivitis were significant risk factors (P values: 0.001, 0.0001, and 0.04, respectively). Hydrops represents a significant independent risk factor for surgery (P = 0.0001). Patients with younger age at onset (P value 0.01), history of eye rubbing (P value 0.02), and atopy (P value 0.01) had higher risk for developing corneal hydrops. This knowledge of risk factors should enable clinicians and patients to make more informed decisions regarding the management of keratoconus.