Prevalence of keratoconus among patients seeking laser vision correction in Taif area of Saudi Arabia

Purpose: To determine the prevalence of keratoconus among patients seeking laser vision correction (LVC). Methods: Retrospective study of 1374 eyes of 687 patients (335 males, 352 females) who underwent keratoconus screening as a part of routine preoperative evaluation prior to LVC at the Tadawi surgical centre, Taif, Saudi Arabia from January 2014 to June 2015. The diagnosis of keratoconus was based on evaluation of Pentacam derived parameters. Results: Manifest keratoconus was found in 59 subjects (out of 687 subjects) representing a prevalence rate of 8.59%. Of the 687 subjects, 45 subjects (6.55%) had bilateral manifest keratoconus (manifest keratoconus in both eyes or manifest keratoconus in one eyes and sub-clinical in contralateral eye) and remaining 14 patients (2.04%) had unilateral manifest keratoconus (with normal fellow eye). Sub-clinical keratoconus was diagnosed in 65 patients representing a prevalence rate of 9.46%. Of the 687 patients, 20 cases (2.91%) with subclinical keratoconus were bilateral and 45 (6.55%) were unilateral. Overall, 19.70% males (66/335) and 16.48% (58/352) females had either manifest or sub-clinical keratoconus, representing no statistically significant difference in the gender predisposition of the keratoconus disease process (Chi Square test; p = .277). Conclusion: High prevalence of keratoconus was found among patients seeking LVC. Possible factors contributing to the high prevalence were recognized to be highly selective population (patients seeking LVC for myopia/hyperopia/astigmatism), ethnicity (high prevalence of consanguinity) and geographical location (high altitude) of the study subjects.