Spang A., Kienecker C., Ruprecht K. W.

Universitäts-Augenklinik, Kirrbergerstr. 1, D- 66424 Homburg, Germany

Introduction: The simultaneous occurrence of keratoconus and atopic disease is well known. Review of the literature show great variations concerning the prevalence of atopic disease in keratoconus patients. The intension of this study was to evaluate the incidence and extent of atopic disease in patients with keratoconus.
Methods: In a retrospective study including 169 patients with keratoconus, confirmed by computerized corneal topography the extent of keratoconus was determined by corneal curvature readings. Allergic symptoms assessed by detailed history are documented.The incidence and degree of atopy in relation to the extent of the keratoconus were evaluated.
Results: In 169 patients, aged between 13 and 77 years, 77 patients (45,6%) had no signs of atopic disease, 92 patients (54,4%) reported allergic problems. Due to advanced keratoconus a corneal transplantation had been performed in 35 patients (20,7%). The incidence of atopic disease increased from 49,2% in patients with early keratoconus to 62,9% in patients status post penetrating keratoplasty. A correlation between steepening of the cornea and higher degree of atopic disease was not observed.
Conclusion: Allergic problems can be expected in more than fifty percent of the keratoconus patients. This can lead to problems in contact lens fitting or to complications after keratoplasty surgery. Solutions for contact lens care and eye drops without preservatives are therefore advantageous.

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