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J.K. Kristinsson, A.N. Carlson, T. Kim; Keratoconus and Obesity - A Connection? . Invest. Ophthalmol. Vis. Sci. 2003;44(13):812.
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Purpose: Several reports have speculated on a mechanical etiology for keratoconus, such as in floppy eyelid syndrome, which is primarily found in obese individuals. We examined the correlation between keratoconus and obesity compared to a control group. Methods: A retrospective search was performed through records of patients undergoing penetrating keratoplasty (PK) for keratoconus up to three years prior to the date of study. Patients undergoing penetrating keratoplasty for corneal scarring were selected as a control group. Results: We found that patients undergoing PK for keratoconus were on average 14.4 kilograms heavier than the control group, which was statistically significant (p=0,015). The difference was even more significant when body mass index (BMI) was compared between the groups. Although the average BMI value was high in both groups, 52,8% of the keratoconus groups fulfilled the criteria of severe obesity, compared with 23,5% of the controls (p=0.006). Conclusions: This study indicates that obesity may play a role in the etiology of keratoconus. We hypothetize that obesity may decrease the elastin in the tarsal plate, possibly making the eyelid skin weaker and decrease it's function in protecting the cornea, for example during sleep. This could predispose to chronic mechanical irritation of the cornea, which has been postulated to be one of likely factors in the pathogenesis of keratoconus.
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