title: The Dundee University Scottish Keratoconus Study II: a prospective study of optical and surgical correction.
abstract: OBJECTIVE
  To investigate and correlate optical correction, and progression to penetrating keratoplasty (PKP), with the corneal, refractive, topographic and familial characteristics of subjects with keratoconus, within the Tayside region of Scotland.
  
  
  METHODS
  Prospective, observational, longitudinal study design. Two hundred subjects with keratoconus were enrolled into the Dundee University Scottish Keratoconus Study (DUSKS) and were assessed during a 4-year period using standardised clinical assessment, computerised corneal topography and questionnaires.
  
  
  RESULTS
  Keratoconic subjects in this study wore rigid contact lenses (90.6%) for longer than 12 hours per day (81%), 7 days a week (91%) and achieved a very good level of Snellen visual acuity (97%, > or =6/9). Corneal staining was observed in the majority of corneas (71%), although only a small percentage of subjects reported major problems of: discomfort (18%), hyperaemia (16%), or the lens falling out (4%). Poor visual acuity was the main reason (79%) for undergoing PKP usually in the latter part of the third decade of life, approximately a decade after diagnosis. During the study period 4% of eyes progressed to PKP. Only a small percentage of eyes (9.5%) required no visual correction postoperatively.
  
  
  CONCLUSIONS
  The main mode of visual rehabilitation for keratoconus was rigid contact lenses, which were mostly worn successfully with good visual acuity. During the study period a small minority of keratoconics progressed to corneal graft surgery. It is advisable to emphasise that postoperatively refractive correction will be required in the majority of these cases.
authors.affiliation: Department of Ophthalmology, Ninewells Hospital and Medical School, Dundee DD1 9SY, UK. k.h.weed@dundee.ac.uk
authors.forename: K H
authors.initials: KH
authors.lastname: Weed
authors.forename: C J
authors.initials: CJ
authors.lastname: Macewen
authors.forename: C N J
authors.initials: CN
authors.lastname: McGhee
mesh_terms: D000293:Adolescent; D000328:Adult; D003261:Contact Lenses; D005260:Female; D006801:Humans; D007640:Keratoconus / Q000503:physiopathology / Q000534:rehabilitation / Q000628:therapy*; D015948:Keratoplasty, Penetrating / Q000379:methods*; D008137:Longitudinal Studies; D008297:Male; D011446:Prospective Studies; D012606:Scotland / Q000453:epidemiology; D014786:Vision Disorders / Q000209:etiology; D014792:Visual Acuity