Analysis of the correlation between ophthalmic examination and quality of life outcomes following intracorneal ring segment implantation for keratoconus
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2011
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Purpose: To analyze the correlation between quantitative measurements outcomes
and keratoconus patients’ vision related quality of life (v-QoL) following intrastromal
corneal ring segment implantation.
Methods: The NEI-RQL (National Eye Institute Refractive Error Quality of Life) was
administered to patients requiring intrastromal corneal ring segment implantation,
before and after surgery, wearing best correction for 40 days minimum. Visual acuity,
refraction, corneal topography, aberrometry data (VOL-CT. software) and contrast
sensitivity were recorded before and 3 months after surgery. The main outcome
measures were best corrected visual acuity, refraction, steep keratometric value (Kmax),
aberrometry, contrast sensitivity and v-QoL.
Results: There were 42 keratoconic patients (69 eyes): 19 male and 23 female, mean
age 24.9 ± 5 years in this prospective study. Binocular best corrected visual acuity
improved (0.13 ± 0.03 before to -0.01 ± 0.01 logMAR after surgery, p<0.001). There
was a statistically significant improvement in mean spherical refraction (2.81 ± 0.44
to 1.71 ± 0.31), cylinder component (3.89 ± 0.22 to 1.82 ± 0.21), spherical equivalent
(4.55 ± 0.46 to 2.40 ± 0.30), Kmax (55.92 D ± 0.62 to 52.16 D ± 0.58 D) and root mean
square low order (p<0.001). Contrast sensitivity (CS) improved at all spatial frequen-
cies: at 6 cpd improvement was higher. Root mean square higher order did not
improved p=0.422. There was significant improvement across all NEI-RQL scales
after surgery. Multivariate analysis showed that gender (males more satisfied than
females), cylinder (1 D reduction improves 5 points in general NEI-RQL scores) and
normal contrast sensitivity at 3 and 6 cpd were correlated with v-QoL. Other variables
such as best corrected visual acuity, root mean square low order, root mean square
higher order and Kmax did not show influence on NEI-RQL scores.
Conclusions: The best patient response predictors with the NEI-RQL instrument
were gender, normal CS at 3 and 6 cpd and cylinder reduction. The use of this ques-
tionnaire was crucial to assess the influence of optical tests on v-QoL in keratoconus
patients who were referred for intrastromal corneal ring segment implantation.
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Cornea, Aberrometry, Corneal topography, Visual acuity, Corneal stroma/surgery, Patient satisfaction, Keratoconus, Quality of life, Keratoplasty, penetrating, Córnea, Topografia da córnea, Aberrometria, Substância própria/cirurgia, Acuidade visual, Ceratocone, Satisfação do paciente, Ceratoplastia penetrante, Qualidade de vida
Citação
PARANHOS, Juliane de Freitas Santos et al. Analysis of the correlation between ophthalmic examination and quality of life outcomes following intracorneal ring segment implantation for keratoconus. Arquivos Brasileiros de Oftalmologia, São Paulo, v. 74, n. 6, p. 410-413, 2011.