SEARCHCROSS-SECTIONALophthalmology, cornea

cross-sectional·ophthalmology, cornea, refractive surgery, clinical trial·PMC10841772

Preferred practice patterns for keratoconus: An e-survey among Indian cornea specialists

Indian Journal of Ophthalmology · 6 authors, 4 centres

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TL;DR

An e-survey of 234 Indian cornea specialists found high availability of Scheimpflug imaging (91.5%), corneal cross-linking (92.7%), and scleral contact lenses (71.4%), but a concentration of trained specialists in urban private facilities raising equity concerns. Epithelium-off accelerated CXL and DALK were the most commonly reported treatment approaches.

Full summary

503 CHARS

An online cross-sectional survey was distributed to all 912 members of the Cornea Society of India via Google Forms, yielding 234 respondents (25.7% response rate) over a 20-day period. Most respondents (88.4%) worked in private eye care facilities and (76.1%) in cities. A Scheimpflug device, Rose K or scleral lenses, and CXL were significantly more available in private facilities. Spectacles were the preferred optical method (91.0%), and topography-guided PRK the preferred surgical method (37.6%).

STUDY TYPE

cross-sectional

SPECIALTY

ophthalmology

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100% · A

ORIGINAL PAPER

PMC10841772

Preferred practice patterns for keratoconus: An e-survey among Indian cornea specialists

Indian Journal of Ophthalmology

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ABSTRACT

Abstract Purpose: This study aimed to report practice patterns in the management of keratoconus in India. Methods: An e-survey was conducted among members of the Cornea Society of India to assess preferred practice patterns for keratoconus. Results: Of the 912 members, 234 (25.7%) completed the survey. About 88.4% worked in private eye care facilities and 76.1% in cities. Of all the respondents, 91.5% had access to a Scheimpflug-based device or an Orbscan II ® ; 71.4% of the respondents dispensed scleral contact lenses, and 66.7% dispensed Rose K contact lenses; 92.7% of the respondents performed corneal cross-linking (CXL); and 73.1% of the respondents performed deep anterior lamellar keratoplasty (DALK). A Scheimpflug device or Orbscan II ® , Rose K or scleral contact lenses, and CXL were more readily available ( P < 0.05) in private eye care facilities. The diagnostic criteria for keratoconus followed by the majority of the respondents (52.1%) were increase in corneal curvature, elevation, and thickness. An increase in keratometry values greater than 0.5 or 1.0D in a 6-month to 1-year period was considered the most favored criterion for keratoconus progression. Epithelium-off, 0.1% riboflavin solution in dextran, and accelerated protocol were the more commonly reported techniques in CXL. About 77.2% of the respondents routinely performed CXL in corneas <400 microns thick. Spectacles (91.0% of the respondents) and topography-guided photorefractive keratectomy (37.6% of the respondents) were, respectively, the preferred optical and surgical methods used to improve vision. Conclusion: While keratoconus management in India is comparable to other developed healthcare systems, the concentration of trained corneal surgeons in cities and private eyecare facilities may lead to less equitable distribution of treatment across the country. Keywords: Corneal cross-linking, keratoconus, online survey, practice patterns, Scheimpflug imaging, treatment

CITATION EXPORT

Neha Kapur, Samrat Chatterjee, Sharad Nivrutti Gomase et al.. Preferred practice patterns for keratoconus: An e-survey among Indian cornea specialists. Indian Journal of Ophthalmology. (2023). https://doi.org/10.4103/IJO.IJO_817_23

AUTHORS

6 · 4 CENTRES

Neha Kapur, Samrat Chatterjee, Sharad Nivrutti Gomase, Ashi Khurana, Gautam Parmar, Virendra Singh Sangwan

1Department of Cornea and Anterior Segment, Dr Shroff’s Charity Eye Hospital, New Delhi, India
1Department of Cornea and Anterior Segment, MGM Eye Institute, Raipur, Chhattisgarh, India
2Department of Cornea and Anterior Segment, CL Gupta Eye Institute, Moradabad, Uttar Pradesh, India
3Department of Cornea and Refractive Surgery, Sadguru Netra Chikitsalaya, Chitrakoot, Madhya Pradesh, India