Evaluation of keratoconus patients with or without surgery by both sub-scales of “Keratoconus End-Points Assessment Questionnaire”

PURPOSE: The purpose of the study was to evaluate the results of Keratoconus End-Points Assessment Questionnaire (KEPAQ) in patients who did or did not have any surgery for keratoconus.
METHODS: This cross-sectional, single-center, observational study included 127 patients with keratoconus at the Cornea Service, Department of Ophthalmology, Dokuz Eylul University. Patients were classified as Group 1 (no ocular surgery) and Group 2 (any surgery for keratoconus). Best-corrected visual acuity (BCVA), spherical equivalent (SE), keratometry readings (Kmean), asphericity coefficient (Q value), and central corneal thickness values were recorded. Patients were asked to answer the questions of emotional (E) and functional (F) KEPAQ subscales.
RESULTS: Group 1 consisted of 59 patients (46.5%), and Group 2 consisted of 68 patients (53.5%). In Group 2, 33 patients had cross-linking (CXL), 16 had intrastromal corneal ring segment (ICRS) implantation, 4 had both CXL and ICRS implantation, 5 had deep anterior lamellar keratoplasty (DALK), and 10 had penetrating keratoplasty (PK). KEPAQ-E scores were positively correlated with BCVA (r=0.34, p<0.01) and SE (r=0.20, p=0.04). KEPAQ-F scores were positively correlated only with BCVA (r=0.25, p=0.01). In Group 2, the worst E and F scores were found in patients who had ICRS implantation and PK, whereas the best E and F scores were obtained in patients who underwent DALK.
CONCLUSION: In this study, BCVA appeared to be the most important predictor of emotional and functional QoL, followed by SE. Other clinical parameters used to stage disease severity did not show any significant correlation with functional or emotional QoL measures.

Keywords: KEPAQ-E, KEPAQ-F, Keratoconus end-points assessment questionnaire, Keratoconus, Quality of life