Revising the Question of Keratoconus Classification

Abstract

Aim: To develop a new surgical keratectasia classification. Materials and methods: We did analysis of existing variants of classification of keratectasia, discussion of newly appeared classifications. We discussed advantages and disadvantages of the presented information. We also discussed the decision of a question on creation of the optimum approach to surgical treat- ment of patients depending on a kind and a stage of keratectasia. Results: Keratectasias were classified according to the pres- ence of the ectatic process progression (progressive and stable); type of ectasia (primary and secondary); ectasia sym- metry (symmetrical and nonsymmetrical); stages (0, I, II, III and IV). The following are recommended for each stage: Subclinical stage 0: Observation and check-up every 6 months; stage I: Ultraviolet (UV) cross-linking; stage II: Intracorneal ring seg- ments (ICRS) implantation, UV cross-linking only if residual ametropia correction by photorefractive keratectomy (PRK) or toric intraocular lenses (TIOL) implantation is planned; stage III: Deep anterior lamellar keratoplasty (DALK); stage IV: penetrat- ing keratoplasty (PK). Conclusion: The presented keratectasia classification is based on modern diagnostic methods; it allows to determine the tactic of surgical treatment, depending on the type and stage of the pathological process. Clinical significance: Our classification helps doctors to easily put the stage of keratoconus process and decide on the follow- ing surgical treatment. Keywords: Cross-linking, Implantation of toric intraocular lenses, Intrastromal corneal ring segments, Keratoconus, Keratoconus classification, Keratoplasty. How to cite this article: Izmaylova S, Komarova O, Semykin A, Konovalova M, Zimina M. Revising the Question of Keratoconus Classification. Int J Kerat Ect Cor Dis 2018;7(1):82-89. Source of support: Nil Conflict of interest: None