Keratoconus Phenotypes based on Corneal Topography, Tomography, and Aberrometry: A Morphological-surgical Classification

IntroductIonThe successful keratoconus treatment through intrastromal corneal ring segments (ICRS) implantation is founded on two pillars: Firstly, to classify the keratoconus morphology by assessing the information obtained by corneal topography, tomography, and aberrometry; secondly, to reshaping corneal morphology through a customized ICRS implantation strategy. [1][2]][3][4][5][6][7][8][9][10][11] Consequently, for a successful keratoconus treatment with ICRS, the first step is to characterize and classify the keratoconus' morphology.The classical morphological classifications, pioneered by Rabinowitz, coexist with the evolutive classifications. 12-20However, it is worth noting that each classification's main aim is different.While morphological classifications focus on describing the keratoconus shape, the evolutive classification aims to stage the keratoconus at the diagnosis moment and evaluate the disease progression.From a therapeutic perspective, the morphological classifications are helpful for the treatment approaches that aim to reshape corneal morphology.In contrast, the evolutive classifications are useful to evaluate the efficacy of the treatments aiming to halt the disease progression.This article presents a morphological classification based on corneal topography, tomography, and aberrometry parameters with the aim of establishing customized treatment strategies focused on reshaping corneal morphology and improving the visual quality of the patients with keratoconus.