PURPOSE: To study keratoconus disease carrier patients in an age range under the usual one and try to detect any factor which can influence in disease evolution and prognosis. METHODS: Patients under 15 years old with a keratoconus diagnosis where analyzed. All of them answered a questionnaire, and were submitted to ocular examination and also computerized ceratoscopy. These patients were divided into three groups and went through a contact lens test: 1) it was possible for this group to adapt to contact lenses; 2) a cornea transplant for this group was recommended; 3) for this group it was suggested that they use glasses. RESULTS: Patients who had 20/40 or greater visual acuity usually did not progress to transplant in the studied period. On the other hand, patients who had 20/60 or less acuity, progress to a deep transplant very quickly. Other cases, related to a lower age range (10-15 years old) pregressed to a transplant. We can observe that the cornea apex has a very unsteady location, which explains the different difficulty levels regarding adaptation to contact lenses. In all patients who had a superior out of place apex and values greater than 66 D adaptation was successful. In the central apex eyes the adaptation was easier. In the inferior apex eyes it was not possible to set a standard to indicate the person for surgery. In the eyes which were adapted to the contact lenses and whose curvature was smaller than 51.10 D there were fewer chances of evolution to a cornea transplant, on comparison with patients who had a curvature of 57.60 or even greater. CONCLUSION: Patients who have curvatures greater than 57.40, acuity lower than 20/60 and are under 18 years old have more chances to evolve to a cornea transplant. When the ceratocone apex is central the contact lens adaptation becomes easier.
Keratoconus; Prognosis; Corneal transplantation; Contact lenses; Visual acuity
