Current phenotype of keratoconus patients at King Khaled Eye Specialist Hospital

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To identify the characteristics of Keratoconus (KC) patients referred to the largest tertiary eye institute in Saudi Arabia (SA).


Chart review of 483 patients from Jan. to Dec 2010. Amsler-Krumeich classification was used for severity staging.


The mean age of 944 eyes at diagnosis and referral were 21.6 and 28.1 years, respectively. Male to female ratio was 2:1. Mean central corneal thickness was 390 (range, 221-619) um. Staging asymmetry between both eyes in bilateral (95.4%) cases were present in 53.8%. Male patients were diagnosed in mild stage (stage1), while, female patients in advanced one (stage 4). Advanced stage was significantly diagnosed at mean age of 19.76 years. Uncorrected visual acuity decreased with increasing disease staging (≥20/80 in 46.4% of stage 1, while < 20/200 in 39.1% of stage 4). Best corrected visual acuity, with either spectacles or contact lenses (CL), was ≥ 20/40 in 79.7% of eyes. Less eyes achieved 20/40 with spectacles in comparison to those fitted with CL. Single or combined management included: spectacles (15.4%), CL (57.6%), corneal collagen cross-linking (3.9 %%), corneal rings (10.6%) and keratoplasties (39.3%). Corneal rings were required in mild (62%), moderate (35%), and advanced (3%) stages. Sub-epithelial and deep stromal scarring was present in 61.2% of eyes which required keratoplasties, and 2/3 of which were having moderate and advanced stages. Male patients tended significantly to have keratoplasty done at 20-30 years, while, female patients at >30 years of age.


Our KC patients are similar to those reported in Indians with regards to early disease-onset, advanced stages, rapid progression, more scarring & lower contact lens wearers.

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