Observational comparative study of different predictive scores of infraclinic keratoconus in refractive laser surgery in case of recused patients

Abstract

AbstractPurpose INTRODUCTION : The surgical laser treatment of refractive disorders is becoming more and more prevalent. Preoperative evaluation means are multiple and all seem promising in the detection of infraclinic keratoconus. Our purpose was to compare the different scores. SETTING : Review of cases, ophthalmology and refractive surgery unit, Percy Military Hospital, Clamart, France.Methods MATHERIAL AND METHODS : Retrospective monocentric observational study, conducted between november 2013 and may 2014. Each patient benefited from an exhaustive corneal topography assessment : Pentacam® and a Belin/Ambrosio ehancement (P/B), Orbscan® and SCORE analyzer by Gatinel & Saad (O/S), and an Ocular Response Analyzer (ORA). A systematic analysis of the following was conducted : the thinnest point of pachymetry (TP), the value of maximum posterior elevation (MPE), the I‐S ratio (IS), the maximum keratometry (K max), the presence of SRAX, and the enantiomorphism.Results RESULTS : 36 myopic patients, recused from laser refractive surgery, were included, or 72 eyes. Suspect cases added up to 31 patients for P/B, 32 for O/S, and 27 for ORA (or respectively 52, 55 and 40 eyes). There were 9 cases of discordance between the different scores. The averages were respectively : 502 +/‐ 47 µm for P, 26.81 +/‐ 7.46µm for MPE, 0.78 +/‐ 0.55 for IS, 44.6 +/‐ 1.8D for K‐max.Conclusion CONCLUSION : Each of the exams and indices studied led us to detect infraclinic keratoconus, but in discordant cases, a more detailed analysis of the topographic map remains essential.