A new approach to keratoconus detection based on corneal morphogeometric analysis

Purpose: To characterize corneal structural changes in keratoconus using a new morphogeometric approach and to evaluate its potential diagnostic ability. Methods: Comparative study including 464 eyes of 464 patients (age, 16 and 72 years) divided into two groups: control group (143 healthy eyes) and keratoconus group (321 keratoconus eyes). Topographic information (Sirius, CSO, Italy) was processed with SolidWorks v2012 and a solid model representing the geometry of each cornea was generated. The following parameters were defined: anterior (Aant) and posterior (Apost) corneal surface areas, area of the cornea within the sagittal plane passing through the Z axis and the apex (Aapexant, Aapexpost) and minimum thickness points (Amctant, Amctpost) of the anterior and posterior corneal surfaces, and average distance from the Z axis to the apex (Dapexant, Dapexpost) and minimum thickness points (Dmctant, Dmctpost) of both corneal surfaces. Results: Significant differences among control and keratoconus group were found in Aapexant, Aapexpost, Amctant, Amctpost, Dapexant, Dapexpost (all p 0.05, R2 Nagelkerke: 0.926). The overall percentage of cases correctly classified by the model was 97.30%. Conclusions: Our morphogeometric approach based on the analysis of the cornea as a solid is useful for the characterization and detection of keratoconus.