Vision-related quality of life low in patients who underwent PK for keratoconus

Am J Ophthalmol. 2010;149(3):416-422.

Patients reported low vision-related quality of life despite experiencing positive visual outcomes from penetrating keratoplasty for keratoconus, according to a study.

The authors used the National Eye Institute Visual Function Questionnaire (NEI-VFQ) to determine vision-related quality of life in keratoconus patients who underwent PK. Scores were compared to those of the Collaborative Longitudinal Evaluation of Keratoconus (CLEK), a historical control group.

"PK is highly successful in [keratoconus] patients, but is not a cure for vision-related [quality of life] issues," the study authors said. "The results of the CLEK study raised the question as to whether patients' vision-related [quality of life] would be better after PK, but these results do not support this. PK in [keratoconus] continues to be indicated for contact lens failures."

The study included 149 patients with a mean age of 53.9 years who underwent PK for keratoconus and subsequently completed the NEI-VFQ. Investigators evaluated relationships between demographic and clinical factors and NEI-VFQ subscores. The primary outcome measure was vision-related quality of life.

About half of the patients underwent bilateral PK. About 80% of patients had visual acuity better than 20/40, and 60% of patients had visual acuity of 20/25 or better in the better-seeing eye.

Study data showed that the patients had significantly lower NEI-VFQ scores compared with the CLEK control group on the subscores of role difficulty, dependency, driving and peripheral vision. NEI-VFQ scores generally fell between scores of patients with age-related macular degeneration categories 3 and 4.

Patients with visual acuity of 20/40 or better in the better-seeing eye had significantly higher scores on all subscores except for color vision compared with patients with visual acuity of 20/40 or worse, the authors reported.

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