Secondary Logo

Journal Logo

Institutional members access full text with Ovid®

Keratoconus Clinical Findings According to Different Classifications

Naderan, Mohammad MD; Shoar, Saeed MD; Kamaleddin, Mohammad A. PhD; Rajabi, Mohammad T. MD; Naderan, Morteza MD; Khodadadi, Marjan MD

doi: 10.1097/ICO.0000000000000537
Clinical Science

Purpose: To demonstrate the topographic and keratometric findings in patients with keratoconus (KC), according to age, sex, and KC severity groups.

Methods: A total of 2073 eyes of 1081 patients with KC were consecutively diagnosed and enrolled in this prospective cross-sectional study. All patients underwent ophthalmic examination and Pentacam (Oculus Optikgerate GmbH) measurements. The patients were divided into different groups according to their age, sex, Amsler–Krumeich classification, and keratoconus severity score classification. Keratometric (K) values (flattest, steepest, and mean), central and thinnest corneal thickness, and manifest refraction were recorded for each patient with KC and they were then compared according to the patient's age, sex, and KC severity groups.

Results: The age (mean ± SD) of the population was 24 ± 7 years. The average central corneal thickness and mean K of all patients were 462 ± 45 μm and 48.8 ± 4.8 diopters, respectively. Female patients with KC were significantly younger and had significantly higher K values and lower anterior chamber depth than those of men. All parameters except for the pupil diameter and astigmatism were significantly associated with KC severity grades. The thinnest corneal thickness was the most important and also the most sensitive and specific parameter for distinguishing all stages of KC severity in all KC severity classifications. The Amsler–Krumeich classification had the most correlation with other severity classifications.

Conclusions: The results of this study enable clinicians and researchers to understand better the differences between clinical characteristics between sex, age groups, and the changes in clinical characteristics during disease progression, which may lead to further advancement in KC management.

Supplemental Digital Content is Available in the Text.

*School of Medicine, Tehran University of Medical Sciences, Tehran, Iran;

Department of Biotechnology, College of Science, University of Tehran, Tehran, Iran; and

Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran.

Reprints: Mohammad Naderan, MD, School of Medicine, Tehran University of Medical Sciences, Tehran 1336616351, Iran (e-mail:

The authors have no funding or conflicts of interest to disclose.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (

Received March 09, 2015

Received in revised form May 22, 2015

Accepted May 25, 2015

Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.