ESCRS 2025: Keratoconus and Secondary Ectasia

Early Cardiac Markers in Young Patients with Keratoconus: Can Cornea Be the Mirror of the Heart

Presenter: Serap Karaca

Keratoconus (KC)–related cardiovascular alterations were evaluated in a prospective study at Istanbul Medeniyet University including 46 KC patients and 30 controls without cardiac disease. The mean age was 29.5 years in the KC group and 42.9 years in controls. 

Echocardiographic and vascular assessments showed significant differences in left ventricular global longitudinal strain (LVGLS, p=0.0004), right ventricular fractional area change (RVFAC, p=0.021), tricuspid annular plane systolic excursion (TAPSE, p=0.002), and augmentation index (p=0.007), indicating subclinical cardiac remodeling. No differences were observed in body mass index (BMI), cholesterol, or blood pressure. These findings suggest KC patients exhibit early cardiac and vascular alterations, underscoring the need for proactive cardiovascular monitoring.

Can Immune Modulators Help in Stabilizing Keratoconus: An Algorithmic Approach

Presenter: Abha Shah

Keratoconus (KC) is an ectatic corneal disease associated with inflammatory biomarkers. This single-center prospective study evaluated 350 eyes randomized into Group 1 (placebo, N=175) and Group 2 (biomarker therapy with trehalose and/or cyclosporine, N=175). Tear samples were analyzed for matrix metalloproteinase-9 (MMP-9), tumor necrosis factor-alpha (TNF-α), and interleukin-6 (IL-6). 

Progression, defined by increases in maximum keratometry (Kmax), myopic shift, cylinder, or corneal thinning, occurred in 121 Group 1 eyes, with findings of collagen weakening and Bowman’s layer thinning. Group 2 showed stabilization in 150 eyes, with mean Kmax change of 0.99 D and 50–60% biomarker reduction. Biomarker-targeted therapy may slow KC progression by reducing inflammation and preserving corneal integrity.

European Society of Cataract and Refractive Surgeons (ESCRS) Congress 2025, September 12-16, Denmark