Methods: We collected 3794 corneal images from 542 eyes of 280 subjects and developed seven deep learning models based on anterior and posterior eccentricity, anterior and posterior elevation, anterior and posterior sagittal curvature, and corneal thickness maps to extract deep corneal features. An independent subset with 1050 images collected from 150 eyes of 85 subjects from a separate center was used to validate models. We developed a hybrid deep learning model to detect KCN. We visualized deep features of corneal parameters to assess the quality of learning subjectively and computed area under the receiver operating characteristic curve (AUC), confusion matrices, accuracy, and F1 score to evaluate models objectively.

Results: In the development dataset, 204 eyes were normal, 123 eyes were suspected KCN, and 215 eyes had KCN. In the independent validation dataset, 50 eyes were normal, 50 eyes were suspected KCN, and 50 eyes were KCN. Images were annotated by three corneal specialists. The AUC of the models for the two-class and three-class problems based on the development set were 0.99 and 0.93, respectively.

Conclusions: The hybrid deep learning model achieved high accuracy in identifying KCN based on corneal maps and provided a time-efficient framework with low computational complexity.