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Unilateral Keratoconus: Videokeratography and Orbscan Study—Optical Correction

Objectives: To assess the frequency of unilateral keratoconus (KC) and vision correction with a contact lens (CL) in the KC eye. Methods: Transverse study in which we revised the clinical records of 385 KC patients. Of these, 35 (9%) showed clinical unilateral KC. Corneal topography was evaluated by a Placido disk and an elevation topographer. We also determined distance and near visual acuity before and after correction with spectacles or CL in KC eye. Results: Mean central corneal curvature (K) of the KC eyes was 51.45 ± 6.65 D, versus 43.58 ± 1.71 D for the fellow eye (P<0.001). Mean maximum curvature of the inferior cornea was 54.62 ± 5.91 D in the KC eye and 44.66 ± 2.38 in the fellow eye (P<0.001). Mean of the thinnest point pachymetry was 411 ± 55 &mgr;m in the KC eye and 477 ± 42 &mgr;m in the contralateral eye (P<0.0001). In most of the 29 patients in whom CLs were fitted, aspheric rigid gas-permeable CLs were used, corrected visual acuities were significantly better (P<0.0001) than without correction. Conclusions: All unilateral KC patients showed higher corneal curvature in the affected eye. Corneal thickness was likewise clearly reduced in the KC eye, and reduced with respect to normal values in the contralateral eye. Aspheric rigid gas-permeable CL were the most effective for improving distance and near visual acuity in patients with adequate tolerance.