April 2011
Volume 52, Issue 14
ARVO Annual Meeting Abstract  |   April 2011
Study Of Normogram For Advanced Keratoconus
Author Affiliations & Notes
  • Sriharsha Nagaraj
    Narayana Nethralaya, Bangalore, India
  • Harsha Nagaraja
    Fellow - Cornea and Refractive Surgery,
    Narayana Nethralaya, Bangalore, India
  • Ashwini Ranganath
    Narayana Nethralaya, Bangalore, India
  • Manisha Bajaj
    Fellow - Cornea and Refractive Surgery,
    Narayana Nethralaya, Bangalore, India
  • Rohit Shetty
    Cornea and Refractive Surgery,
    Narayana Nethralaya, Bangalore, India
  • Footnotes
    Commercial Relationships  Sriharsha Nagaraj, None; Harsha Nagaraja, None; Ashwini Ranganath, None; Manisha Bajaj, None; Rohit Shetty, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science April 2011, Vol.52, 5175. doi:
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      Sriharsha Nagaraj, Harsha Nagaraja, Ashwini Ranganath, Manisha Bajaj, Rohit Shetty; Study Of Normogram For Advanced Keratoconus. Invest. Ophthalmol. Vis. Sci. 2011;52(14):5175.

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      © ARVO (1962-2015); The Authors (2016-present)

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Purpose: : To attempt a Normogram for advanced Keratoconus

Methods: : Retrospective non-randomized non-bllinded observational study of 527 patients with keratoconus,3 year study, in tertiary care referral hospital. The patients were categorized into following 6 groupsGroup 1 - 125 eyes were managed conservatively with contact lens & glassesGroup 2 - 175 eyes treated with collagen crosslinkingGroup 3 - 107 eyes treated with C3R + IntacsGroup 4 - 25 eyes treated with ICL phakic lensesGroup 5 - 45 eyes treated with TopoPRK+C3RGroup 6 - 57 eyes underwent keratoplasty

Results: : Normogram was designed based progression, centred or decentered cone, grade of keratoconus and age at presentation. Non progressive keratoconus (Group 1 ) were managed conservatively with contact lens and younger patients were given option of ICL phakic lenses (Group 4, n=25), these patients showed good improvement in vision and >95% of them showed >2lines BCVA improvement at end of 6 months. In progressive keratoconus with central cone (Group 2) were managed with C3R alone and then contact lens were given, 20 patients in this group underwent ICL for power correction at end of 6 months. In decentered keratoconus (Group 3), intacs was done initially and C3R done after 1 month (n=45) and in advanced central cone keratconus(simk >55D) both C3R + Intacs done simultaneously (n=62 eyes). In Advanced decentered keratoconus (Group 5, n=45),who were not suitable for intacs alone, were treated with TopoPRK +C3R and 10 eyes underwent intacs after 6 months. In corneas with very advanced keratoconus with scarring (Group 6, n= 35 eyes) underwent lamellar keratoplasty, 22 eyes underwent intralase enabled keratoplasty. Outcomes, safety, efficiacy, complications associated with each group were analyzed and studied to help us in understanding the development of the normogram.

Conclusions: : Our study attempts to provide normogram for management of advanced keratoconus. This normogram takes into factors like age, centration of cone, progession, grading of keratoconus, patient satisfaction and quality of life to provide a simple algorithm for management.

Keywords: keratoconus • cornea: clinical science • refractive surgery 

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