Background and Objective: Keratoconus (KC) is a progressive ocular disorder affecting the cornea, which is the outer layer of the eye, causing gradual thinning and protrusion, leading to a conical shape and visual distortion. The aim of this study was to investigate the severity of KC with clinical characteristics of people with visual impairment.
Methods: In this cross-sectional study, 525 eyes in 276 patients with visual impairment in seven provinces in central and southern Iraq, including Al-Basrah, Mesan, Wasit, Babel, Al-Najaf, Kerbala, and Dhi-Qar, were studied from February 2022 to March 2023. Patients were classified into four groups based on disease severity and stage: non-keratoconus with astigmatism>1 diopter (D), mild KC, moderate KC, and severe KC. Keratoconus severity was assessed based on gender, age, total corneal thickness (TCT), keratometry (K), and astigmatism.
Findings: Out of 525 eyes, 363 normal eyes, 92 mild KC eyes, 32 moderate KC eyes, and 38 severe KC eyes were included. The mean age of the patients was 27.13±10.05. Only astigmatism showed a statistically significant association with age group achieving a p-value of 0.024 and total corneal thickness with gender group with a p-value of 0.031. Overall, the sample in this study had at least 1.0 D of corneal astigmatism. A linear regression model was utilized to assess the relationship between KC severity and astigmatism, keratometry, and central corneal thickness, which provide significant results, achieving a p-value of <0.001.
Conclusion: The results showed varied patterns of KC distribution among individuals aged 10 to 76 years, as well as significant differences in the severity of the KC. Furthermore, the findings indicated that total corneal thickness steadily declines as keratoconus becomes more severe. Astigmatism and keratometry readings are increasing.
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