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J. F. S. Paranhos, P. Schor, M. P. Avila, A. Paranhos, Jr.; Clinical Evaluation of Highly Aberrated Eyes: The Importance of the Patient Self Perception. Invest. Ophthalmol. Vis. Sci. 2009;50(13):3542.
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To prospectively evaluate the outcome of Keraring® intracorneal ring segments (ICRS) implantation on quality of life (QOL) of patients with keratoconus using the NEI-RQL (National Eye Institute Refractive Error Quality of life) instrument.
The NEI-RQL was administered to patients that had indication for ICRS implantation before and after one month best correction wearing. Visual acuity, refraction, corneal topography (CT) and contrast sensitivity (CS) data was recorded before and 3 months after surgery. Aberrometry data was obtained from CT using VOL-CT®software.
Sixty nine eyes of 42 patients (19 men) were included in this study. Mean age was 24,9 years. The mean overall quality of life questionnaire scale increased from 31,88 ±14,4 to 64,7 ±12,9 after surgery (p<0,001). The most sensitive subscales were "clarity of vision", "near vision", "far vision", "activity limitation", "appearance" and "satisfaction", 25 to 50 before surgery to 80 and 90 after it. CS improved in all frequencies (p<0,005). Patient quality of life was related to gender (male more satisfied than female), cylinder (1,00D reduction on cylinder makes the general satisfaction rise 5 scores), and CS at frequencies of 3 and 6 cpd. Quality of life were not influenced by age, educational level, RMS LO and HO, SE, Kmax, visual acuity and pupil diameter.
CT and aberrometry don't fully explain clinical results and patient's satisfaction after ICRS implantation. Quality of life improvement is related to cylinder reduction and normal CS of 3 and 6 cpd. We advocate the use of optical tests in conjunction to questionnaires when evaluating human highly aberrated visual systems.
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