Corneal volume, pachymetry, and correlation of anterior and posterior corneal shape in subclinical and different stages of clinical keratoconus

• Published in: Journal of cataract and refractive surgery Vol. 36; no. 5; pp. 814 - 825
• Main Authors: Piñero, David P., MSc, Alió, Jorge L., MD, PhD, Alesón, Alicia, OD, Vergara, Munir Escaf, MD, Miranda, Mauricio, MD
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01-05-2010; Elsevier
• Subjects: Adolescent; Adult; Anthropometry; Astigmatism - diagnosis; Biological and medical sciences; Cornea - pathology; Corneal Topography; Diseases of cornea, anterior segment and sclera; Endothelium, Corneal - pathology; Epithelium, Corneal - pathology; Female; Humans; Imaging, Three-Dimensional; Keratoconus - classification; Keratoconus - pathology; Male; Medical sciences; Middle Aged; Ophthalmology; Refraction, Ocular - physiology; ROC Curve; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the eye and orbit; Visual Acuity - physiology; Cornea; Correlation; Shape; Pachymetry; Anterior; Keratopathy; Asymptomatic; Eye disease; Treatment; Keratoconus; Volume; Surgery; Posterior; Ophthalmology; Anterior segment disease
• ISSN: 0886-3350; 1873-4502
• DOI: 10.1016/j.jcrs.2009.11.012

Purpose To evaluate the corneal volume, pachymetry, and correlation of anterior and posterior corneal shape in subclinical and clinical keratoconus. Setting Vissum Corporation, Alicante, Spain. Methods Eyes were placed into 1 of 4 groups as follows: keratoconus 2 (grade II), keratoconus 1 (grade I), subclinical (subclinical keratoconus), and control (normal eyes). All eyes had an ophthalmologic examination including corneal evaluation (curvature, elevation, asphericity, pachymetry, corneal volume) by rotating Scheimpflug imaging (Pentacam). The posterior–anterior corneal power ratio was also calculated. Results Seventy-one eyes (51 patients; aged 16 to 64 years) were evaluated. Astigmatism and keratometry of both corneal surfaces were statistically significantly higher in the keratoconus 1 and 2 groups ( P ≤.02). Posterior astigmatism was statistically significantly higher in the subclinical group than in the control group ( P = .01). A strong correlation ( r ≥−0.81) was found between anterior and posterior curvature in the normal and subclinical groups; the correlation was weaker in clinical keratoconus cases ( r ≤−0.56). The correlation in astigmatism between the anterior and posterior surface was good in all keratoconus groups ( r ≥0.81). The posterior–anterior corneal power ratio was significantly higher in the keratoconus 2 group than in the other groups ( P ≤.01). Pachymetric readings were progressively lower in eyes with subclinical, early, or moderate keratoconus ( P <.01). The corneal volume was statistically significantly lower in the keratoconus 2 group than in the other groups ( P = .04). Conclusion The correlation between anterior and posterior corneal curvature was lower in keratoconus, although the correlation between anterior and posterior astigmatism was maintained. Financial Disclosure No author has a financial or proprietary interest in any material or method mentioned.