Keratokonus Hastalarında Yaş, Cinsiyet ve Kontakt Lens Tipinin Hastalığın Progresyonuna Etkisi

Abstract

Patients who applied to Hacettepe University Ophthalmology Department Cornea Unit and were followed up with the diagnosis of keratoconus were included in the study. Eyes of these patients with keratoconus with at least 1 year of follow-up data were included in the study. Patients with a genetic or allergic history or a history of ocular surgery were not included in the study. Information about the age, gender, diagnosis, history of ocular surgery, history of underlying genetic or allergic predisposing condition, contact lens usage status and, if contact lens use, the type of lens used in these cases can be found in the archives of Hacettepe University Ophthalmology Department Cornea Unit and obtained from hospital digital recording systems. During the follow-up of the patients, SimK1, SimK2, SimKavg, Central Corneal Thickness (CCT) and Corneal Apex Curvature (Kmax) values of the topographic measurements made with the Sirius (CSO, Florans, Italy) corneal topography device were recorded. In the measurements of the patients included in the evaluation, attention was paid to ensure that the accuracy of the measurements was sufficient ("Acquisition Quality"), that there was 1 year between the initial and final measurements, and that the patients did not undergo any ocular intervention during or before this period. It was examined how the topographic measurements of the patients changed according to age, gender, contact lens use status and contact lens type if they used contact lenses within 1 year. The criteria for progression were between the first and last measurement (ie, within 1 year); (1) Steep K (K2) ≥ 1 D increase, (2) Kort ≥ 0.75 D increase, (3) Corneal Apex Curvature (Kmax) ≥ 1 D increase, and (4) Central Corneal Thickness (CCT) ≥ 2% decrease, and the presence of one of these criteria was evaluated in favor of disease progression. Statistical analysis of the data was performed with the Statistical Program for Social Sciences (SPSS) version 22.0. In our study, the progression status of the eyes of the patients diagnosed with keratoconus was compared according to the lens use, and progression was observed in 80 of the eyes that did not use lenses with a rate of 60,6%, while progression developed in 25 of the eyes using lenses with a rate of 42,4%, and this difference was found to be statistically significant (p= 0.019). Considering the progression according to age, progression was observed in 79 eyes with a rate of 61.2% of eyes under 30 years of age, while progression developed in 26 eyes with a rate of 41.9% in patients over 30 years of age. The rate of development of keratoconus progression in the eyes of patients under 30 years of age was statistically significantly higher (p=0.009). When the progression development of the eyes of the patients diagnosed with keratoconus was compared according to gender, no statistical difference was found (p>0.05). As a result, within the limits of this study, it was observed that the use of lenses in eyes with keratoconus had positive effects on progression. There was no effect of gender difference on the progression of keratoconus disease. It is known that keratoconus progression is more common in younger patients.