33-year analysis highlights earlier keratoconus diagnosis and advanced treatment trends

Over the past 33 years, advancements in diagnostic methods and treatment options have led to earlier detection and improved management of keratoconus, resulting in increased use of contact lenses and collagen crosslinking (CXL), reducing the need for invasive keratoplasty surgeries, with a shift towards less invasive procedures like deep anterior lamellar keratoplasty (DALK), according to a study.

The study analyzed data from 20,576 patients diagnosed with KC in at least 1 eye between 1987 and 2020.

There was a significant decrease in the mean age at diagnosis of keratoconus, from 29.3 years (1987-1991) to 22.2 years (2016-2020), indicating earlier detection over time. Adults comprised 76.64% of cases, with a male predominance of 61.25%. The use of contact lenses among patients increased from 4.34% (2002-2006) to 11.23% (2016-2020). Collagen crosslinking (CXL) treatment became more common, rising from 22.28% (2007-2011) to 53.61% (2012-2016) and 72.53% (2017-2020). In addition, advancements in surgery led to more patients choosing DALK over traditional penetrating keratoplasty. In the last 8 years, 17.2% of patients had surgery, with CXL being the most frequent (14.77%), followed by DALK (1.72%), and penetrating keratoplasty (1.04%).

Reference
Deshmukh RS, Das AV, Vaddavalli PK. Evolving Trends in the Diagnosis and Management of Keratoconus Over 3 Decades. Cornea. 2024;doi: 10.1097/ICO.0000000000003635. Epub ahead of print. PMID: 39012335.