Prevalence of Abnormal Ectasia Screening Indices and the Predictive Value of Anterior Keratometry in…

Cross-sectionalKorean journal of ophthalmology : KJO· Jul 2026

Prevalence of Abnormal Ectasia Screening Indices and the Predictive Value of Anterior Keratometry in Refractive Surgery Candidates.

Kyo Youn Jeong, Gyuwon Ryu, Moonwon Hwang

Cataract & RefractiveCross-sectionalDiagnosisQ2IF 1.3

Anterior keratometry alone only modestly predicts abnormal corneal tomography screening results

Prevalence of Abnormal Ectasia Screening Indices and the Predictive Value of Anterior Keratometry in Refractive Surgery Candidates.

Kyo Youn Jeong … Moonwon Hwang

Korean journal of ophthalmology · Jul 2026 · Q2 in Ophthalmology

Purpose

To determine the prevalence of abnormal ectasia screening indices among refractive surgery candidates and whether autorefraction-keratometry (autorefraction-keratometry) can discriminate patients with abnormal Pentacam indices well enough to triage tomographic referral.

Methods

In this retrospective, cross-sectional study, 1,985 of 2,000 consecutive refractive surgery candidates with complete autorefraction-keratometry and Pentacam data were analyzed.

n = 1,985 patients

Results

keratometry alone was only moderately accurate at flagging abnormal corneal scans

AUC 0.72 (95% CI 0.69 to 0.74)

null 0

0.69

0.74

CI excludes the null - significant

More results

Screening-positivity was present in 25.0% of patients (95% CI, 23.1-26.9), whereas clearly-abnormal indices occurred in only 2.4% (1.8-3.1); positivity was driven mainly by the borderline BAD-D > 1.6 flag.

At a sensitivity of 95%, only 16.2% of patients could safely forgo tomography, and 100% sensitivity spared just 1.9%.

“

Conclusion · 1 of 2

Abnormal ectasia screening indices were common but predominantly borderline, and anterior keratometry alone could not reliably triage which corneas require tomographic examination.

Conclusion · 2 of 2

They support routine tomographic evaluation where available and indicate that keratometry alone cannot replace it where it is not.

Prevalence of Abnormal Ectasia Screening Indices and the Predictive Value of Anterior Keratometry in Refractive Surgery Candidates.

Prevalence of Abnormal Ectasia Screening Indices and the Predictive Value of Anterior Keratometry in Refractive Surgery Candidates.

Related papers