title: Quality of life in keratoconus patients after penetrating keratoplasty.
abstract: OBJECTIVE
  To determine vision-related quality of life (QoL) measured with the National Eye Institute Visual Function Questionnaire (NEI-VFQ) in keratoconus (KCN) patients who have undergone penetrating keratoplasty (PK) in 1 or both eyes and to compare the results of our study to those of historical controls.
  
  
  METHODS
  Clinical-based, cross-sectional study.
  
  
  METHODS
  
  
  
  METHODS
  Wills Eye Institute, Cornea Service, Thomas Jefferson University, Philadelphia, Pennsylvania.
  
  
  METHODS
  This study included 149 consecutive patients who had undergone PK for KCN.
  
  
  METHODS
  Between June 1, 2008 and December 31, 2008, the NEI-VFQ was administered to 149 patients. The relationship between demographic and clinical factors and NEI-VFQ subscale scores was evaluated.
  
  
  METHODS
  Vision-related quality of life.
  
  
  RESULTS
  Eighty-three of 149 patients (55.7%) were male. Approximately half of the patients (76/149; 51.0%) had PK in both eyes. Visual acuity with current correction in the better eye was better than 20/40 in 80% of patients (119/149). Our sample had significantly lower (worse) NEI-VFQ scores compared to Collaborative Longitudinal Evaluation of Keratoconus (CLEK) historical control group for the subscales of role difficulties, dependency, driving, and peripheral vision. In general, scores of our sample were between scores of patients with age-related macular degeneration (AMD) category 3 and 4. Patients with visual acuity better than 20/40 (in the better eye) showed significantly higher scores in all subscales except color vision. There was a significant relationship between minimum time since the graft of 5 years or greater and NEI-VFQ overall score better than AMD category 3 (P = .004).
  
  
  CONCLUSIONS
  Despite satisfactory results on visual outcome measures obtained after PK, vision-related QoL in KCN patients remains impaired.
authors.affiliation: Cornea Service, Wills Eye Institute, Jefferson Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania 19107, USA.
authors.forename: Elvin H
authors.initials: EH
authors.lastname: Yildiz
authors.forename: Elisabeth J
authors.initials: EJ
authors.lastname: Cohen
authors.forename: Ajoy S
authors.initials: AS
authors.lastname: Virdi
authors.forename: Kristin M
authors.initials: KM
authors.lastname: Hammersmith
authors.forename: Peter R
authors.initials: PR
authors.lastname: Laibson
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Rapuano
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007640:Keratoconus / Q000503:physiopathology / Q000601:surgery*; D015948:Keratoplasty, Penetrating; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D018434:Sickness Impact Profile; D011795:Surveys and Questionnaires; D014785:Vision, Ocular / Q000502:physiology*; D014792:Visual Acuity / Q000502:physiology