Posters

Long-term vision-related quality of life following intrastromal corneal ring segment implantation for advanced keratoconus

Poster Details

First Author: J. Court UNITED KINGDOM

Co Author(s):    M. Muhtaseb                    

Abstract Details

Purpose:

To report the long-term vision related quality of life (VQoL) in patients treated with INTACS SK intrastromal corneal ring segments (ICRS) to manage advanced keratoconus using the National Eye Institute Visual Function Questionnaire-25 (NEI-VFQ-25).

Setting:

Singleton Hospital, Abertawe Bro Morgannwg University Health Board, Swansea, United Kingdom

Methods:

INTACS SK ICRS were manually implanted in 30 patients with moderate to advanced keratoconus (defined as mean keratometry (K) >53.0 dioptres (D), or keratometric astigmatism >4D with a mean K of 49.0-53.0D), where regular INTACs were likely to have limited results, as a strategy for delaying the need for keratoplasty. Patients were sent a postal questionnaire to self-administer the NEI-VFQ-25. Patients with a minimum of 5 years follow-up were included. Results were compared to the Collaborative Longitudinal Evaluation of Keratoconus (CLEK) historical control group and the Wills Eye Institute 'Quality of Life in Keratoconus Patients after Penetrating Keratoplasty' study (QLPK).

Results:

The mean length of follow-up was 6.85 years (range 5.5 to 8.5 years). Visual acuity in the better eye was better than 0.3LogMAR in 80% of patients. Visual acuity with current correction was significantly improved 5 years post-operatively versus pre-operatively (0.58 vs 1.24LogMAR, p<0.01). Our sample had worse NEI-VFQ-25 scores for general vision compared to CLEK and QLPK (54.7 vs 74.3 and 73.6, p<0.01). Ocular pain scores also showed a trend towards being worse in our INTACS SK group than in the CLEK or QLPK groups (60.9 vs 74.8 and 75.8, p=0.09 and 0.07).

Conclusions:

ICRS implantation achieved improved visual acuity measures in advanced keratoconus, with stability over 5 years of follow-up. However, VQoL remained impaired. Corneal transplant may offer improved VQoL over ICRS in advanced keratoconus in the longterm but a larger head-to-head study, including lamellar keratoplasty, is needed to verify our findings.

Financial Disclosure:

NONE