title: Femtosecond laser-assisted LASIK improves quality of life.
abstract: OBJECTIVE
  To investigate the quality of life (QOL) outcomes of femtosecond laser-assisted LASIK using the Quality of Life Impact of Refractive Correction (QIRC) questionnaire.
  
  
  METHODS
  Translation of the QIRC questionnaire from English to Greek followed standard international protocols. The questionnaire was completed by 190 individuals, aged 18 to 39 years with myopia (range: -0.75 to -8.50 diopters) and corrected distance visual acuity (CDVA) of logMAR 0.2 or better (Snellen equivalent 20/32) in the worse eye. Half of this sample underwent LASIK with femtosecond laser flap creation and ablation with the Visx Star S4 IR excimer laser (Abbott Medical Optics). The questionnaire was scored with Rasch analysis. Validity was tested by internal consistency reliability (Cronbach's α) and repeatability by intraclass correlation coefficient (ICC) and Bland-Altman limits of agreement, convergent validity was examined with inter-item correlations, and construct validity was evaluated by known groups comparison analysis.
  
  
  RESULTS
  The total QIRC score improved with femtosecond laser-assisted LASIK from mean 38.9±5.7 preoperatively to 53.7±5.1 postoperatively (P<.001). Among the pre-treatment and control groups, QIRC score was greater for those wearing contact lenses than those wearing spectacles (P<.01). The Greek version of the QIRC had good internal consistency reliability. Inter-item correlations were all significant (P<.001), ranging from 0.32 to 0.79. Repeatability was high (Bland-Altman limits of agreement were -6.72 to +5.41 and ICC for the total score was 0.98).
  
  
  CONCLUSIONS
  Femtosecond laser-assisted LASIK leads to marked improvements in refractive error-related quality of life. This study also provides evidence for the reliability and validity of the Greek version of the QIRC questionnaire.
authors.affiliation: Center of Health Services Research, Department of Hygiene, Epidemiology and Medical Statistics Medical School, Athens, Greece. alex_p_mei@yahoo.com
authors.forename: Alexandra
authors.initials: A
authors.lastname: Meidani
authors.forename: Chara
authors.initials: C
authors.lastname: Tzavara
authors.forename: Christina
authors.initials: C
authors.lastname: Dimitrakaki
authors.forename: Konrad
authors.initials: K
authors.lastname: Pesudovs
authors.forename: Yannis
authors.initials: Y
authors.lastname: Tountas
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D020731:Keratomileusis, Laser In Situ; D007802:Language; D054018:Lasers, Excimer / Q000627:therapeutic use*; D008297:Male; D009216:Myopia / Q000503:physiopathology / Q000601:surgery*; D011788:Quality of Life; D012029:Refraction, Ocular / Q000502:physiology; D015203:Reproducibility of Results; D018434:Sickness Impact Profile; D011795:Surveys and Questionnaires; D014792:Visual Acuity / Q000502:physiology; D055815:Young Adult