Abstract
Abstract: :
Purpose: We report the impact of penetrating keratoplasty (PK) on vision–related quality of life in a prospective cohort of patients with keratoconus. Methods: Our sample consisted of patients in the CLEK study who underwent their first PK during follow–up and completed the NEI–VFQ (VFQ). CLEK patients completed the VFQ at their first annual follow–up visit and annually thereafter. VFQ scores at this Year 1 visit were used as baseline. We compared the PK group to the baseline scores of patients who did not undergo PK (non–PK). Scores prior to PK and the two visits after PK are reported for the first eye undergoing the surgery. For patients subsequently undergoing PK in the fellow eye (resulting in bilateral PK), we report VFQ scores from the final CLEK visit. Results: The VFQ was administered to 1,166 CLEK patients at the Year 1 follow–up visit. One hundred eighteen CLEK patients underwent PK through Year 7. The VFQ was not available at CLEK enrollment, thus only 75 of these 118 patients completed the VFQ prior to PK. Of the 118, 117 completed the VFQ at the first annual visit after PK and 92 at the second. At the annual CLEK visit prior to PK, patients had significantly lower scores than the non–PK group on all scales. Patients had significant improvement on 2 of 12 scales at the first post–PK visit, but remained significantly lower than the non–PK group on all scales. Significant improvement was reported on 10 of 12 scales at the second CLEK visit post–PK, but remained significantly below the non–PK group on 6 of 12 scales. Patients with bilateral PK had scores comparable to, or higher, than the non–PK group on 11 of 12 scales at their final CLEK visit, but scores remained below an age–similar group of rigid gas permeable (RGP) contact lens wearers on all but one scale. Conclusions: We found that both unilateral and bilateral post–PK patients have impaired vision–related quality of life when compared to RGP wearers of similar age . There is a need for a better understanding of the impairments in quality of life that are associated with keratoconus and the role of PK in its management.
Keywords: keratoconus • quality of life • clinical (human) or epidemiologic studies: outcomes/complications