Purchase this article with an account.
Muriel Schornack, Cherie B Nau, Jennifer S Harthan, Jennifer Swingle Fogt, Ellen Shorter, Amy Catherine Nau; Long-Term Management of Patients with Keratoconus. Invest. Ophthalmol. Vis. Sci. 2021;62(8):2037.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
This study will examine the practice patterns of long term management of keratoconus patients including follow up visit, frequency of topography and surgery.
An internet-based, 22 question, IRB approved RED-Cap survey of providers who managed at least one KC patient per week. Descriptive analyses are presented. Some responses allowed more than one answer.
Of the 296 respondents, 245 providers with an average of 23.1 +12 years in practice met entry criteria. Respondents (n=220) averaged caring for 27.2 +35 KC patients each month. Respondents follow stable KC patients as follows: 6 month intervals (n=76) or 12 months (n=142). Stable patients were administered topography as follows (n=299): Initial visit (n=91), every follow up visit (n=43), only if progression suspected (n=31), every 6 months (n=26), every year (n=126),more than a year (n=25). Most practitioners (n=222) follow unstable KC patients at 3 month (n=78) or 6 month (n=134) intervals, while few follow them annually (n=10). Unstable KC is followed with topography as follows (n=299): at every follow up (n=101), only if indicated (n=27) every 6 months (n=99) every 12 months (n=29). Respondents recommend crosslinking in the following situations (n=221): All patients (n=16), documented diseases progression regardless of age (n= 118), documented progression under 40 (n=75), Other (n=12). Respondents were asked to estimate the percentage of patients who had undergone crosslinking. Results were as follows (n=212): 0-10% (n=86), 11-25% (n=82), 26-50% (n=38), 51-75% (n=13), 76-100% (n=3). Respondents (n=222) were asked to estimate the percentage of patients with KC who had undergone corneal transplantation. Results were as follows: 0-10% (n=104), 11-25% (n=90), 26-50% (n=26), 51-75% (n=2), greater than 75% (n=0).
Practice patterns for long term management of keratoconus show wide variability in terms of follow up care and assessment of progression with point of care testing. While respondents stated that they often recommend crosslinking, there are still few patients who have undergone the procedure. Results from this survey support the recent trend for fewer patients with corneal transplants. Better patient outcomes might be achieved with more defined algorithms for follow up care and point of care testing.
This is a 2021 ARVO Annual Meeting abstract.
This PDF is available to Subscribers Only