Keratoconus Clinical Trial
To describe the clinical course of keratoconus and to describe the relationships among its
visual and physiological manifestations, including high- and low-contrast visual acuity,
corneal curvature, slit lamp biomicroscopic findings, corneal scarring, and quality of life.
To identify risk factors and protective factors that influence the severity and progression
of keratoconus.
Keratoconus is a bilateral, asymmetric, chronic, progressive ectasia of the cornea
characterized by steepening and distortion of the cornea, thinning of the apical cornea,
corneal scarring, and treatment-related sequelae, such as abrasions from contact lenses and
surgical complications. Patients experience distorted vision that worsens with disease
progression. Their vision is typically corrected with spectacles early in the disease and,
later, with rigid contact lenses. Some patients eventually undergo corneal transplantation
in one or both eyes. Keratoconus affects people in their prime earning years and profoundly
affects their lives.
Previous large-scale studies of keratoconus have focused on incidence and prevalence,
etiologies, or the clinical management of keratoconus. Few have characterized the course of
the disease and risk factors for its progression in large samples of keratoconus patients.
The incidence of vision-threatening corneal scarring in keratoconus is unknown. Patient's
most frequent questions--how rapidly their keratoconus will progress, how bad their vision
will become, whether they will need corneal surgery, how successful their contact lenses
will be--cannot be answered on the basis of the current body of knowledge.
The need for a prospective, observational study of keratoconus patients is great. Results
from this study will address keratoconus patient's unanswered questions and will enable eye
care practitioners to manage this complex ocular disease better.
The Collaborative Longitudinal Evaluation of Keratoconus (CLEK) Study is a multicenter,
observational study of 1,209 keratoconus patients followed for 3 years.
Patients are examined annually. Study measures include visual acuity, patient-reported
quality of life, manifest refraction, keratometry, photodocumentation of the cornea to
identify central corneal scarring, photodocumentation of the flattest contact lens that just
clears the cornea, slit lamp biomicroscopy, and corneal topography. In rigid contact lens
wearers, the fluorescein pattern of the patient's habitual contact lenses is
photodocumented.
Patients are examined at 15 clinical centers. The clinical centers enrolled 1,209 patients
in 12 months.
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Time Perspective: Prospective
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