title: Vision-Related Quality of Life Before and After Deep Anterior Lamellar Keratoplasty.
abstract: OBJECTIVE
  To determine changes in the vision-related quality of life in patients undergoing deep anterior lamellar keratoplasty (DALK) by using the 25-item National Eye Institute Visual Function Questionnaire (NEI VFQ-25).
  
  
  METHODS
  Thirty-five patients who were scheduled for DALK between March 1, 2013, and March 1, 2014 were asked to complete the NEI VFQ-25. NEI VFQ-25 was administered again at 6 months and at 1 year postoperatively. Data on patients' age, sex, preoperative diagnosis, preoperative and postoperative best-corrected visual acuity, and postoperative astigmatism were recorded.
  
  
  RESULTS
  Successful DALK with the Anwar big bubble technique was achieved in 23 of 35 (65.7%) patients. The indications for surgery were keratoconus in 15 patients (62.2%), stromal corneal dystrophies in 4 (17%), and corneal scar in 4 (17%). The mean preoperative NEI VFQ-25 composite score (55.2±19.7) improved significantly (76.9±11.6) at 6 months after DALK and continued to improve (84.3±6.6) at 1 year postoperatively (Friedman test, P=0.001). All NEI VFQ-25 subscale item scores increased significantly after surgery. The patients' age was significantly correlated with the NEI VFQ-25 subscale score of mental health at 6 month and at 1 year postoperatively (r=0.92, P=0.008 and r=0.94, P=0.005, respectively). There was a negative relationship between postoperative astigmatism at 1 year and NEI VFQ-25 ocular pain, social functioning, peripheral vision, and mental health subscale scores (r=-0.76, P=-0.07; r=-0.53, P=0.2; r=-0.53, P=0.27; r=-0.80, P=0.05).
  
  
  CONCLUSIONS
  Vision-related quality of life improved significantly after DALK and continued to improve after suture removal.
authors.affiliation: Ministry of Health, Department of Ophthalmology, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey.
authors.forename: Elvin
authors.initials: E
authors.lastname: Yildiz
authors.forename: Meltem
authors.initials: M
authors.lastname: Toklu
authors.forename: Ece
authors.initials: E
authors.lastname: Turan Vural
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D001251:Astigmatism / Q000523:psychology; D003316:Corneal Diseases / Q000523:psychology / Q000601:surgery*; D016039:Corneal Transplantation / Q000379:methods; D058447:Eye Pain / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods; D011183:Postoperative Complications / Q000523:psychology; D011446:Prospective Studies; D011788:Quality of Life; D011795:Surveys and Questionnaires; D014792:Visual Acuity