At the 2024 ESCRS Meeting in Barcelona, Prof. Farhad Hafezi, MD, PhD, FARVO from the ELZA Institute provided an insightful update on the Second Global Consensus on Keratoconus during an interview with EyeTube. This significant initiative builds on the groundbreaking 2015 consensus, addressing advancements in keratoconus evaluation and treatment.
From the First to the Second Consensus: The Journey
The First Global Consensus on Keratoconus, published in 2015, was a pivotal milestone in understanding and managing this complex corneal disease. Led by José Alvaro Gómez, it brought together experts from four supranational cornea societies to address key topics: definition/diagnosis, clinical treatment, and surgical management. The document, developed using the Delphi method, reflected prevailing expert opinions and was widely cited, shaping clinical practices globally.
Recognizing the rapid advancements in keratoconus management over the past decade, the need for a more inclusive and updated consensus emerged. The Second Global Consensus, initiated in 2023, expands on its predecessor by involving a larger, more diverse group of experts and addressing new topics in keratoconus care.
Expanding the Scope: A More Inclusive Approach
Prof. Hafezi emphasized the Second Consensus’s broader inclusivity, achieved by incorporating nine supranational refractive societies alongside the original four cornea societies. The panel has grown from 36 to 125 participants, reflecting a truly global representation. This larger team is addressing nine key topics, compared to the three in the first consensus:
- Definition, diagnosis, and staging.
- Clinical treatment and non-invasive visual rehabilitation.
- Cross-linking for progression.
- Invasive visual rehabilitation.
- Keratoplasty approaches.
- Elective refractive surgery.
- Cataract surgery in keratoconus.
- Emerging technologies and treatment modalities.
- Patient-centric approaches.
Progress and Goals
The consensus-building process involves rigorous literature reviews and expert discussions using the Delphi methodology. Virtual meetings have been conducted thus far, with the final in-person session scheduled for the 2024 AAO meeting in Chicago. Following this, the manuscript will be submitted to a high-impact journal in spring 2025, with publication expected by summer 2025.
Key Insights
Prof. Hafezi highlighted two critical areas of focus:
- Invasive Visual Rehabilitation vs. Elective Refractive Surgery: He noted the nuanced distinction between these categories, emphasizing the importance of addressing borderline cases and providing therapeutic solutions for advanced keratoconus.
- Global Impact: By engaging refractive societies and ensuring industry-neutral funding, the Second Consensus aims to provide a comprehensive, unbiased perspective on keratoconus management.
Looking Ahead
As the Second Global Consensus on Keratoconus approaches its final stages, the medical community eagerly anticipates its findings. By integrating the latest scientific advances and clinical insights, this consensus promises to redefine how keratoconus is managed, benefiting patients and practitioners worldwide.
