Vision-Related Quality of Life in Patients With Keratoconus With Enantiomorphic Topography After Bilateral Intrastromal Corneal Ring Implantation

Abstract

Purpose: The aim of this study was to evaluate the quality of life (QOL) after intrastromal ring implantation in patients with keratoconus.

Methods: This was a prospective, randomized, interventional study. We analyzed 60 eyes of 30 patients aged 16 to 35 years who were treated at the Department of Ophthalmology and Visual Sciences, Federal University of São Paulo, Brazil. The Visual Function Questionnaire (VFQ-25) and Short-Form 36 Questionnaire (SF-36) were used before intracorneal ring segment (ICRS) implantation and at 3, 6, and 12 months after surgical intervention.

Results: The mean corrected visual acuity improved from a mean of 0.32 ± 0.2 logMAR (20/40) preoperatively to 0.14 ± 0.11 logMAR (20/25) 1 year postoperatively ( P = 0.001). The mean spherical equivalent varied from -7.24 ± 3.47 preoperatively to -4.13 ± 2.41 postoperatively ( P = 0.001). The overall composite score for the VFQ-25 improved from 55.1 preoperatively to 80.4 1 postoperatively ( P = 0.001). SF-36 showed statistically significant improvement in all scores. When analyzing the correlation between visual acuity and VFQ composite score, a significant correlation was found between both variables (Pearson correlation coefficient of -0.40, P = 0.001).

Conclusions: Patients with keratoconus had increased psychological symptoms and lower QOL and improved psychosocial criteria associated with corneal remodeling and decreased visual dependence on others after surgery. Extrapolation of these data to the whole keratoconus population suggests that ICRS implantation could improve QOL in these patients.