Features of the course and treatment of progressive keratoconus in military personnel

Abstract

Purpose To evaluate the course and treatment of progressive keratoconus in military personnel Setting The study conducted in SI " The Filatov Institute of Eye Diseases and Tissue Therapy NAMS of Ukraine" Methods There were 19 military patients (MP) (26 eyes) with progressive keratoconus under our observation and treatment. In 2022, 5 eyes (19.2%) were treated, and in 2023, 21 eyes (80.7%) were treated. The age of the patients was 32.4±6.34 years (ranging from 19 to 45 years); one woman and 18 men. The causes of keratoconus (KC) progression were visual strain and constant eye rubbing in 5 patients (26.3%), and additional physical exertion in 14 patients (73.7%). KC stages: II - in 3 eyes (11.5%), III - in 21 eyes (80.7%), IV - in 2 eyes (7.7%). Results In the IV stage of the KC (2 eyes) the penetrating keratoplasty was carried out with improving of VA to 0.4. The accelerated CLX was performed on 24 eyes (II and III stages of KC). In 2022, 65 CLX were conducted with 5 (7.7%) MP. In 2023 - 100 CLX, including 19 (19%) of MP. After 6 months: BCVA increased by 0,1 to 0,55±0.35, p=0,16; The corneal thickness was no significant decrease 447±35.4 nm, p=0,5; The degree of astigmatism decreased by 0.67 to 2.77±1.35, p=0,12;The maximum keratometry decreased by 3.62 D to 52.8±6.26 D, p=0,12. Conclusions Among military personnel with KC, patients with stage 3 KC predominated (80.7%). The main surgical intervention was CLX, which increased from 7.7% in 2022 to 19% in 2023. Physical exertion and stress experienced by military personnel with KC can serve as triggers for disease progression. It is advisable to conduct investigations into corneal biomechanics and pachymetry (Pentacam) for monitoring the dynamics of development and timely implementation of corneal CLX to halt the progression of KC and preserve vision in military personnel.