Keratoconus Management Guidelines

Abstract

Degenerative and Chronic Eye Diseases', sub-program 'Ocular Structures and Common Pathologies' (RD12/0034). ACKNOWLEDGMENTS We present this keratoconus management guideline in order to provide an update on the aims and indications of the various therapies used to treat keratoconus. It is an official guide from OFTARED (Ophthalmic Research Collaborative Thematic Network, RD12/0034/007), a network that currently represents the collective efforts of a large number of medical institutions. The aim of these institutions is to improve the practice of ophthalmology through clinical innovation, guided in its practical application by multicenter research methods that generate objective criteria for use. In this sense, this guide constitutes the amalgamation of what we have all learned about treating keratoconus over the past 8 years. A task that began with the first Thematic Network RD07/0062/0018 which was followed by the current OFTARED, RD12/0034/007. During this time, we have constructed a large keratoconus database that may well be the largest in Europe at this time (Iberia Keratoconus Database). The various exploratory methods available today for the diagnosis of keratoconus have been analyzed consecutively with a view to finding how we might gain a better understanding of how this corneal pathology develops, and then how best to treat it. As a result of this joint effort by the Thematic Network, OFTARED-RETICS, a new keratoconus classification system based on visual acuity has been established as well as an improved method to indicate intracorneal segments based on corrected vision (published in Am J Ophthalmol 2013;155(3):575-584). Numerous studies by our multicenter working group have led to a better understanding of the behavior of this disease under different circumstances, and in particular how it responds to treatment using modern innovative corrective methods based on corneal molding and stiffening. Readers will also learn how our collective efforts have achieved an approach to treat a disease once thought to be rare and now very common in clinical practice, while remaining independent of commercial constraints. We hope that this keratoconus management guideline will prove useful to you all. Many clinical researchers have dedicated great time and effort to create something that aims to serve all of us and that will help improve patient care and their prognosis.