title: Impact of Collagen Cross-linking on Psychological Distress and Vision and Health-Related Quality of Life in Patients With Keratoconus.
abstract: OBJECTIVE
  To evaluate the changes in psychological distress level and quality of life (QoL) scores of keratoconus (KC) patients 1 year after corneal collagen cross-linking (CXL).
  
  
  METHODS
  Observational cross-sectional study. Thirty-three, consecutive progressive KC patients who received CXL treatment were enrolled in the study. All patients were evaluated before and 1 year after CXL ophthalmologically and psychologically. Main outcome measures were the visual, refractive, and topographic changes and the Beck Depression Inventory, State-Trait Anxiety Inventory (STAI), Short Form-36 (SF-36), and The National Eye Institute Visual Function Questionnaire (NEI-VFQ-25).
  
  
  RESULTS
  There were significant improvements in the keratometric readings at flat axis, steep axis, the mean keratometric reading, the corneal astigmatism (Kast), and the maximum keratometric reading. State-Trait Anxiety Inventory-II scores, QoL dimensions, such as physical role difficulty, general health, mental health, ocular pain, near activities, distance activities, peripheral vision, and mental health scores, and the composite score of NEI-VFQ-25, were higher after surgery. There was a positive correlation between the changes observed in Kast and mental health; a negative correlation between the changes in Kast and STAI-II, and a negative correlation between the changes in mental health and STAI-II. Change in STAI-II has significantly predicted the improvement observed in general health.
  
  
  CONCLUSIONS
  Our results suggested lower trait anxiety and better vision-related and health-related QoL in KC patients 1 year after successful CXL treatment. Better QoL in these patients seems to be related not only with the visual and refractive results but also improvement observed in trait anxiety.
authors: Department of Ophthalmology (A.K.C., Y.C., F.M.T., A.Y., A.S.), Faculty of Medicine, Dicle University, Diyarbakir, Turkey; Department of Psychiatry (Y.B.), Faculty of Medicine, Marmara University, Istanbul, Turkey; and Department of Psychiatry (C.T., A.S.), Faculty of Medicine, Dicle University, Diyarbakir, Turkey.
authors: Abdullah Kursat
authors: AK
authors: Cingu
authors: Yasin
authors: Y
authors: Bez
authors: Yasin
authors: Y
authors: Cinar
authors: Fatih Mehmet
authors: FM
authors: Turkcu
authors: Adnan
authors: A
authors: Yildirim
authors: Alparslan
authors: A
authors: Sahin
authors: Cuma
authors: C
authors: Tas
authors: Aytekin
authors: A
authors: Sir
mesh_terms: D000293:Adolescent; D000328:Adult; D001007:Anxiety; D003094:Collagen / Q000378:metabolism; D003432:Cross-Linking Reagents / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D003863:Depression / Q000209:etiology; D005260:Female; D006801:Humans; D007640:Keratoconus / Q000188:drug therapy* / Q000503:physiopathology / Q000523:psychology*; D008297:Male; D011788:Quality of Life; D012029:Refraction, Ocular / Q000502:physiology; D013315:Stress, Psychological / Q000209:etiology*; D011795:Surveys and Questionnaires; D014792:Visual Acuity / Q000502:physiology; D055815:Young Adult
chemical_list: D003432:Cross-Linking Reagents; D003094:Collagen