Introduction
Keratoconus is defined as a progressive, non-inflammatory, bilateral, asymmetrical, corneal disease characterized by paraxial stromal thinning and weakening that leads to distortion of the corneal surface. Its onset occurs anywhere between the ages of 8 and 45. The purpose of this study was to identify the phenotype of keratoconus and investigate its distribution by regions and families among patients seen at King Khalid Eye Specialist Hospital (KKESH) in Riyadh.
Methodology
A retrospective cohort study was conducted at the hospital and 400 patient files were reviewed. Data was collected on a pre-designed data sheetfor patients who had visited the hospital (from first of January to end of February 2012).
Results
Over half(53.0%) of the patients were in the age group 21-30 years (mean 28.1 ± SD 7.2). The most common age at diagnosis was 11-20 years (45.0%) (Mean 21.7 ± SD 6.7) and the most common duration ofdisease (57.5%) was 1-5 years (mean 6.4 ± SD 4.4).Almost two-thirds (67.3%) were males, 38.3% from Southern region, 36.5% from central region and 14.2% fromWestern region.Only 2.0% had positive family history of keratoconus, 97.5% had no history of associated systemic disease, overtwo thirds had no historyof atopy, but16.0% had vernal keratoconjictivitis. Regarding the right eye, out of 387 patients, 43.4% hadminimum keratometry readings of right eye of 45-52 (Moderate)(mean 47.1± SD 6.4), and 36.2%hadmaximum keratometry readings 45-52 (Moderate)(52.1± SD7.7). Out of 390 patients,42.1%had mean keratometry readings of right eye of45-52 (Moderate)with a mean 49.9± SD6.8.Management was by 36% contact lenses, and 12.4%keratoplasty, 19.4%contact lenses and LKP/PKPand 3.8% contact lenses and Ringwere managed by. Regarding the left eye,Out of 383 patients, 39.9% hadminimum keratometry readings 45-52 (Moderate)(mean 47.6± SD 6.4); out of 385 patients,38.2%hadmaximum keratometry readings 45-52 (Moderate) (52.8± SD 7.7). Out of 391 of patient's files,41.9%havemean keratometry readings of left eye of 45-52 (Moderate)with a mean 50.4± SD 6.9. Management was 34.0% by contact lenses, 13.5%keratoplasty, 23.0% contact lenses and LKP/PKP and3.0% contact lenses and ring.
Conclusion
Keratoconus patients in our study had an early age of onset of disease with rapid progression to severe form, with a male and southern region predominance and positive family history of keratoconus with some atopic, genetic and connective tissue disorders. Bilateral disease was seen in most of the patients with high percentage of severe cases by keratometry readings, low corneal thickness and high percentage of corneal scarring. The most common single treatment type was contact lenses followed by keratoplasty. Contact lenses and keratoplasty was the most common combination treatment.