Abstract
Keratoconus is a progressive corneal disorder which is frequently asymmetric. The aetiology of keratoconus remains unclear, and the concept of keratoconus as an ectatic disorder has been challenged recently. We carried out a retrospective study in 160 eyes of 80 patients, to evaluate and compare interocular differences in corneal diameter and surface area in patients with unilateral or highly asymmetric keratoconus (UHAKC). Calculations were performed using raw topographic elevation data derived from topographic measurements using Orbscan II, and we extrapolated surface areas up to measured corneal diameter. We also evaluated inter-eye correlation, and correlation between corneal surface area, corneal diameter and keratoconus severity. Our results showed a statistically significant but not clinically important greater corneal diameter (12.14 mm and 12.17 mm; p = 0.04), and corneal surface area (paired t-test, p < 0.0001; p = 0.0009 respectively) in more affected eyes. Inter-eye comparison revealed corneal diameter, anterior chamber depth, and corneal surface area were strongly correlated between eyes. Corneal surface area remained strongly correlated, and Bland–Altman analysis also showed strong inter-ocular agreement. Our results show that in patients with UHAKC the interocular difference in corneal diameter and corneal surface area is clinically insignificant, and are consistent with a redistribution, rather than increase, of corneal surface area with keratoconus progression.
Highlights
Keratoconus is a progressive corneal disorder which is frequently asymmetric
We report an interocular comparison in patients with unilateral or highly asymmetric keratoconus
As corneal diameter has been shown to be symmetric in normal myopic e yes[11], we studied symmetry of corneal diameter and corneal surface areas in highly asymmetric keratoconus
Summary
Keratoconus is a progressive corneal disorder which is frequently asymmetric. The aetiology of keratoconus remains unclear, and the concept of keratoconus as an ectatic disorder has been challenged recently. We carried out a retrospective study in 160 eyes of 80 patients, to evaluate and compare interocular differences in corneal diameter and surface area in patients with unilateral or highly asymmetric keratoconus (UHAKC). Our results show that in patients with UHAKC the interocular difference in corneal diameter and corneal surface area is clinically insignificant, and are consistent with a redistribution, rather than increase, of corneal surface area with keratoconus progression. We report an interocular comparison in patients with unilateral or highly asymmetric keratoconus. We recently published a case–control study of consecutive Unilateral or Highly Asymmetric Keratoconus (UHAKC) patients diagnosed at the Rothschild Foundation which revealed an association between eye rubbing, incorrect sleeping position and U HAKC7, with eye rubbing and incorrect sleeping position found more frequently in the worse eye. We evaluated inter-eye correlation, and correlation between corneal surface area, corneal diameter, and keratoconus severity
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