Clinical stability in the fellow non‐operated eye from asymmetric keratoconus patients

Abstract

AbstractPurposeTo assess the clinical status of corneal ectasia, including clinical outcomes and tomographic/biomechanical assessments of asymmetric keratoconus patients who had surgical treatment only in the most advanced eye.MethodsThis retrospective study included 100 eyes of 50 asymmetric keratoconus patients who had surgery in one eye. The eyes were divided in two groups, the operated group (OG) which underwent surgery and the fellow non‐operated eyes (NOG). Both groups received medical treatment for ocular allergic disease and ocular surface optimization, along with the general advice to avoid eye rubbing.ResultsMean follow‐up time was 41 ± 33.26 months (range 6.4–182.4) and mean age at the first visit was 25 ± 9.8 years (range 6–60), including 43 patients with less than 34 years. Regarding to the NOG, the baseline average UDVA was 0.40 (20/50) ± 0.46 logMAR and CDVA was 0.10 (20/25) ± 0.17 logMAR. In the last visit, despite of no surgical treatment, average UDVA and CDVA showed improvement to 0.34 (20/44) ± 0.43 (p > 0.05) and 0.06 (20/23) ± 0.15 logMAR (p = 0.02), respectively. Analysis of biomechanical parameters of the NOG showed a statistically significant difference (p < 0.05) of deflection amplitude ratio. The comparison of ABC parameters of Belin’s tomographic grading system between first and last visit showed non statistically significant difference (p > 0.05) in the NOG.ConclusionClinical anti‐allergic and ocular surface optimization treatment, along with patient education for avoiding eye rubbing (as in the Violet June Keratoconus Awarenes Campaign) is indicated to all keratoconus/ectasia patients best first line of treatment. The stability of the ABCD parameters of Belin grading system in the NOG and even the improvement of CDVA supports that, regardless age, in many cases with mild ectasia, medical management is sufficient without the need for surgical procedure, even in young patients.