CHOICE OF SUBJECTIVE OCULAR REFRACTION TECHNIQUE AND CORNEAL TOPOGRAPHY OF KERATOCONUS (RE-CON)

Keratoconus is a rare evolving corneal ectasia that alters visual acuity. To improve spectacle-corrected visual acuity, various subjective refraction techniques can be used. The subjective refraction techniques of keratoconus-carrying patients have never been studied. The main hypothesis is that the most suitable subjective ocular refraction method varies with the corneal topography of the keratoconus. The main objective is to define the most appropriate refractive technique(s) based on corneal topographies in order to provide keratoconus-affected patients with the best spectacle-corrected visual acuity.

Keratoconus is a rare evolving corneal ectasia that alters visual acuity. To improve spectacle-corrected visual acuity, various subjective refraction techniques can be used. The Jackson Cylinder Cross Method, the Astigmatic Dial Technique and the Stenopeic Slit are three validated subjective refraction techniques for measuring astigmatism. The subjective refraction techniques of keratoconus-carrying patients have never been studied. The main hypothesis is that the most suitable subjective ocular refraction method varies with the corneal topography of the keratoconus. The investigators collect several characteristics of corneal topography of the keratoconus : the average value of the keratometry of the 3 central mm called Km ; the value of the point corresponding to the maximum keratometry (called Kmax), the distance between the center and the point of Kmax, (called d_Kmax) ; the corneal surface variance index called ISV ; the Belin/Ambrósio Enhanced Ectasia Display (called BAD-D). The main objective is to define the most appropriate refractive technique(s) based on corneal topographies in order to provide keratoconus-affected patients with the best spectacle-corrected visual acuity.

Keratoconus, Corneal Topography, Eyeglasses, Ocular Refraction, Jackson Cross Cylinder, Astigmatic Dial Technique, Stenopeic slit

Collection of the astigmatism axis given by each method, by the autorefractometer and by the corneal topography

Inclusion Criteria: adult persons patients with keratoconus patients with alteration of visual acuity ability to give informed consent to participate in the study affiliation to a social security scheme Exclusion Criteria: Keratoconus grafted with cornea or with intracorneal rings. Central corneal opacities. Presence of other eye diseases affecting visual acuity. Patients under guardianship, curatorship or justice protection. Pregnant or breastfeeding women. Refusal to participate in the study.

Metzger M, Navel V, Barriere JV, Kwiatkowski F, Hebraud J, Mulliez A, Beral L, Chiambaretta F, Dutheil F. Benefits of using corneal topography to choose subjective refraction technique in keratoconus (RE-CON): a prospective comparative crossover clinical study. Graefes Arch Clin Exp Ophthalmol. 2022 Jan;260(1):197-207. doi: 10.1007/s00417-021-05382-y. Epub 2021 Aug 20.