Quality of Life in Keratoconus Patients After Penetrating Keratoplasty
Accepted 12 October 2009.
Purpose
To determine vision-related quality of life (QoL) measured with the National Eye Institute Visual Function Questionnaire (NEI-VFQ) in keratoconus (KCN) patients who have undergone penetrating keratoplasty (PK) in 1 or both eyes and to compare the results of our study to those of historical controls.
Design
Clinical-based, cross-sectional study.
Methods
setting: Wills Eye Institute, Cornea Service, Thomas Jefferson University, Philadelphia, Pennsylvania. study population: This study included 149 consecutive patients who had undergone PK for KCN. intervention: Between June 1, 2008 and December 31, 2008, the NEI-VFQ was administered to 149 patients. The relationship between demographic and clinical factors and NEI-VFQ subscale scores was evaluated. main outcome measure: Vision-related quality of life.
Results
Eighty-three of 149 patients (55.7%) were male. Approximately half of the patients (76/149; 51.0%) had PK in both eyes. Visual acuity with current correction in the better eye was better than 20/40 in 80% of patients (119/149). Our sample had significantly lower (worse) NEI-VFQ scores compared to Collaborative Longitudinal Evaluation of Keratoconus (CLEK) historical control group for the subscales of role difficulties, dependency, driving, and peripheral vision. In general, scores of our sample were between scores of patients with age-related macular degeneration (AMD) category 3 and 4. Patients with visual acuity better than 20/40 (in the better eye) showed significantly higher scores in all subscales except color vision. There was a significant relationship between minimum time since the graft of 5 years or greater and NEI-VFQ overall score better than AMD category 3 (P = .004).
Conclusion
Despite satisfactory results on visual outcome measures obtained after PK, vision-related QoL in KCN patients remains impaired.
aCornea Service, Wills Eye Institute, Jefferson Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
bMinistry of Health, Ankara Training and Research Hospital, Department of Ophthalmology, Ankara, Turkey
Inquiries to Elisabeth J. Cohen, Cornea Service, Wills Eye Institute, 840 Walnut St, Suite 920, Philadelphia, PA 19107
ABSTRACT