title: Patient subjective visual function after corneal collagen crosslinking for keratoconus and corneal ectasia.
abstract: OBJECTIVE
  To assess subjective visual function after corneal collagen crosslinking (CXL).
  
  
  METHODS
  Cornea and refractive surgery subspecialty practice.
  
  
  METHODS
  Prospective randomized controlled clinical trial.
  
  
  METHODS
  Patients completed a subjective questionnaire regarding visual symptoms administered preoperatively and 1 year after CXL. Patients ranked self-reported symptoms of photophobia, difficulty night driving, difficulty reading, diplopia, fluctuations in vision, glare, halo, starburst, dryness, pain, and foreign-body sensation on a scale from 1 to 5. Possible associations of symptoms with changes in corrected distance visual acuity (CDVA) and maximum keratometry were also analyzed.
  
  
  RESULTS
  One hundred seven eyes of 76 patients had CXL for keratoconus (n = 71) or ectasia (n = 36). The mean preoperative to 1-year postoperative changes in night driving (3.2 ± 1.5 [SD] to 2.8 ± 1.5), difficulty reading (3.1 ± 1.5 to 2.9 ± 1.3), diplopia (2.5 ± 1.3 to 2.1 ± 1.2), glare (3.1 ± 1.4 to 2.7 ± 1.2), halo (2.9 ± 1.4 to 2.5 ± 1.3), starbursts (2.6 ± 1.5 to 2.4 ± 1.4), and foreign-body sensation (1.8 ± 1.1 to 1.6 ± 0.9) were statistically significant. There were no associations between the change in any symptom and changes in CDVA. There was a weak association between the change in night driving, pain, and foreign-body sensations and the change in maximum keratometry.
  
  
  CONCLUSIONS
  After CXL, patients noted subjective improvement in visual symptoms, specifically night driving, difficulty reading, diplopia, glare, halo, starbursts, and foreign-body sensation. These subjective outcomes corroborate quantitative clinical improvements seen after CXL.
authors.affiliation: Cornea and Laser Eye Institute-Hersh Vision Group, CLEI Center for Keratoconus, Teaneck, and Department of Ophthalmology, UMDNJ-New Jersey Medical School, Newark, New Jersey, USA.
authors.forename: Nneka O
authors.initials: NO
authors.lastname: Brooks
authors.forename: Steven
authors.initials: S
authors.lastname: Greenstein
authors.forename: Kristen
authors.initials: K
authors.lastname: Fry
authors.forename: Peter S
authors.initials: PS
authors.lastname: Hersh
mesh_terms: D001334:Automobile Driving; D003094:Collagen / Q000378:metabolism*; D003319:Corneal Stroma / Q000378:metabolism*; D003432:Cross-Linking Reagents / Q000378:metabolism*; D004108:Dilatation, Pathologic / Q000188:drug therapy / Q000378:metabolism; D004172:Diplopia / Q000503:physiopathology; D019466:Glare; D006801:Humans; D007640:Keratoconus / Q000188:drug therapy* / Q000378:metabolism; D017319:Photosensitizing Agents / Q000627:therapeutic use; D011446:Prospective Studies; D011932:Reading; D012029:Refraction, Ocular / Q000502:physiology*; D012256:Riboflavin / Q000627:therapeutic use; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014466:Ultraviolet Rays; D014786:Vision Disorders / Q000503:physiopathology; D014792:Visual Acuity / Q000502:physiology*
chemical_list: D003432:Cross-Linking Reagents; D017319:Photosensitizing Agents; D003094:Collagen; D012256:Riboflavin