Characteristics and clinical outcomes of patients diagnosed with keratocone

ABSTRACT Objectives: To describe the epidemiological and clinical profile, evolution and outcomes of keratoconus patients diagnosed in the ophthalmologic reference service of the state of Santa Catarina, Brazil. Methods: The medical records of all patients with keratoconus attended at the Cornea service of the Regional Hospital of São José, between January 2016 and December 2018 were retrospectively analyzed. The following data were extracted: sex, age, disease stage, systemic diseases, ophthalmological symptoms, adaptation of contact lenses, previous treatments, best monocular visual acuity, keratometric measurements, ophthalmological procedures, clinical outcomes. Results: The medical records of 267 patients were analyzed. The average age was 23 years (range: 06 - 60 years), 159 (59.55%) were male. 12 (4.49%) patients had already performed penetrating keratoplasty; 22 (8.24%) had performed crosslinking; 07 (2.62%) had already an intrastromal ring implant. 81 (30.34%) patients had already adapted contact lenses. 168 (62.92%) had best corrected visual acuity, of the better eye, equal to or greater than 20/40. A distribution between cases was found light, moderate and severe of: 03 (1.12%), 78 (29.21%), 157 (58.80%), respectively. Throughout the period, a total of 51 (73,9%) corneal transplants, were performed 09 (90,0%) intrastromal ring implants, 35 (32,4%) crosslinking, 22 (23,4%) contact lens adaptations were performed; 205 (76.77%) patients lost follow-up, 12 (4.49%) were discharged. Conclusion: The patients are mostly young, with moderate to severe illness and good visual acuity in the best eye. Even so many received a surgical management. The loss of clinical follow-up is an important factor in the quality of ophthalmic care in this population.

摘要
研究目的：描述巴西圣卡塔琳娜州（Santa Catarina）眼科专科诊疗中心（ophthalmologic reference service）确诊的圆锥角膜（keratoconus）患者的流行病学与临床特征、病情进展及转归。
研究方法：对2016年1月至2018年12月期间，圣若泽地区医院（Regional Hospital of São José）角膜专科门诊接诊的所有圆锥角膜患者的病历资料进行回顾性分析。提取的研究数据包括：性别、年龄、疾病分期、全身疾病、眼科症状、接触镜适配情况、既往治疗史、最佳单眼视力、角膜曲率测量结果、眼科手术操作及临床转归。
研究结果：共纳入267例患者的病历进行分析。患者平均年龄为23岁（范围：6~60岁），其中男性159例（占比59.55%）。12例（4.49%）患者已接受穿透性角膜移植术（penetrating keratoplasty）；22例（8.24%）接受过角膜交联术（crosslinking）；7例（2.62%）已行角膜基质内环植入术（intrastromal ring implant）。81例（30.34%）患者已完成接触镜适配矫正。168例（62.92%）患者的较佳眼最佳矫正视力（best corrected visual acuity）大于或等于20/40。按病情轻重分级，轻度、中度、重度患者占比分别为1.12%（3例）、29.21%（78例）、58.80%（157例）。本研究期间共完成角膜移植手术51例（73.9%）、角膜基质内环植入术9例（90.0%）、角膜交联术35例（32.4%）及接触镜适配矫正22例（23.4%）。205例（76.77%）患者失访，12例（4.49%）脱离随访队列。
研究结论：本研究纳入的患者以青年人群为主，多为中重度圆锥角膜，且较佳眼仍保有较好的视力。尽管如此，仍有大量患者接受了外科治疗。临床随访失访是影响该群体眼科诊疗质量的重要因素。