Clinical Report: The Anatomy of Disagreement
Overview
The second Global Consensus on Keratoconus and Ectatic Diseases highlights significant disagreements among experts regarding key diagnostic metrics and definitions. Notably, while Kmax is widely used, its reliability is questioned.
Background
The second edition of the Global Consensus, involving 128 ophthalmologists, aims to address critical areas such as diagnosis, treatment, and surgical interventions.
Data Highlights
No numerical data presented in the article.
Key Findings
- 91.7% of the diagnostic panel agreed that Kmax has low repeatability and reproducibility for evaluating progression.
- 75% of panelists still use Kmax in daily practice despite its unreliability.
- A new staging system for keratoconus was developed based on the Belin ABCD grading.
- The panel could not reach consensus on definitions for 'subclinical keratoconus' and 'forme fruste keratoconus.'
- 71% endorsed biomechanical assessment as a valuable adjunct in refractive surgery screening.
Clinical Implications
Clinicians should be aware of the limitations of Kmax as a progression parameter and consider alternative metrics for evaluating keratoconus. The updated definitions and staging systems may guide more accurate diagnosis and treatment planning.
Conclusion
The second Global Consensus on Keratoconus and Ectatic Diseases reveals critical areas of disagreement.
Related Resources & Content
- Cornea, 2026 -- Global Consensus on Keratoconus and Ectatic Diseases-Edition 2
- Ophthalmology, 2021 -- Effect of Corneal Cross-linking versus Standard Care on Keratoconus Progression in Young Patients
- Eye, 2024 -- Comparison of standard versus accelerated corneal collagen cross-linking for keratoconus: 5-year outcomes from the Save Sight Keratoconus Registry
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- Global Consensus on Keratoconus and Ectatic Diseases-Edition 2 - PubMed
- Effect of Corneal Cross-linking versus Standard Care on Keratoconus Progression in Young Patients - Ophthalmology
- Comparison of standard versus accelerated corneal collagen cross-linking for keratoconus: 5-year outcomes from the Save Sight Keratoconus Registry | Eye
- Paediatric Keratoconus: An ERN-EYE Clinical Consensus Statement on Diagnosis, Treatment and Follow-Up Care - PMC
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