Results of the largest study to date on keratoconus were published in Cornea medical journal this month. Information was collected for over 20,000 patients with keratoconus in the USA and the results were very revealing.
Read on to find out why corneal graft is on the decrease.
Is corneal graft the ultimate treatment?
Keratoconus is a progressive eye disease diagnosed in 1 in 2,000 Australians. Often striking in the teens and progressing through the twenties, the disease is best managed with hard contact lenses and most cases do not require a corneal graft. The results of the latest clinical studies show a marked decline in corneal graft surgery for keratoconic patients over the past ten years or so.
The latest clinical findings
- The rate of corneal graft for keratoconus in the US is decreasing, with the biggest change happening since 2009. This is most likely due to substantial improvement in contact lens technology, with many patients who may have previously needed a transplant now being managed solely with hard contact lenses.
- Rates of corneal transplant for keratoconus patients have declined rapidly in the USA, with over 6% of patients having a graft in 2005, compared to less than 3% of patients in 2010, just five years later.
- The decrease in rates of corneal graft for keratoconus is an international trend.
- Other studies have shown a clear improvement in quality of life reported by contact lens wearers with keratoconus.
Increased rates of corneal graft were associated with the following:
- age 20-40
- male gender
- black race
- lower household worth
- less education
Interestingly, previous studies have shown the age group and racial association, but the latest study also revealed the economic and education factors.
Further findings from the study include:
- Although several ocular and systemic conditions are associated with developing keratoconus, none of these conditions were found to increase the incidence of having a corneal graft.
- Rates of lamellar keratoplasty (partial thickness graft) are not increasing, suggesting that previous full-thickness graft patients are managing their keratoconus with contact lenses rather than other kinds of graft.
What does this mean for today's keratoconus patient?
What the study clearly shows is that the future is looking a lot brighter for even the most severe cases of keratoconus. The vast majority of patients will never need a corneal graft, but even for the worst affected patient, corneal transplant is only being performed in less than 3% of patients with this disease, and the decline in rate seems set to continue. Better contact lens designs and greater expertise and experience around achieving a successful and comfortable fit means your keratoconus need not be a scary diagnosis.