Simultaneous topical application of cyclosporine and trehalose appears to keep keratoconus eyes stable: a prospective, longitudinal case series evaluated with artificial intelligence methods

A prospective, longitudinal case series on keratoconus (KC) eyes was studied where the eyes were treated with topical cyclosporine and trehalose. The study included 362 eyes of 181 patients. The eyes were followed up for a minimum period of 6 months. Corneal tomography was evaluated with Pentacam (OCULUS Optikgerate Gmbh, Germany) at 1st visit and at the last follow-up. Progression was initially evaluated based on change in maximum keratometry (Kmax). Then, this initial classification was assessed with an artificial intelligence model of 31 tomography variables of Pentacam to confirm the inference of progression based on Kmax alone. Based on a change in Kmax of 0.75, 1.0 and 1.25D criteria, more than 90% of the eyes were stable for each criteria at the last follow-up (initial classification). Further analysis with the AI revealed that less than 5% of the eyes had progressed at the last follow-up (final classification). Hence, topical cyclosporine and trehalose appeared to effectively stabilize KC and provide a suitable non-surgical option to manage the inflammation driving the disease.