Corneal Cross Linking Improves Quality of Life in Patients With Keratoconus

Corneal crosslinking halts worsening in keratometric, aberrometric and visual acuity values and positively affects quality of life in patients with keratoconus.

Corneal crosslinking (CXL) can improve quality of life (QOL) by halting the worsening of keratometric, aberrometric, and visual acuity values in patients with keratoconus, according to research published in Contact Lens and Anterior Eye. 

Researchers enrolled 38 participants with progressive keratoconus (mean age, 20.5 years; 81.58% men) in the analysis and administered the keratoconus outcomes research questionnaire (KORQ) before surgery and at 1, 3, and 6 months following the procedure. Participants underwent best corrected visual acuity (BCVA), topographic, aberrometric and pachymetric assessment in both eyes and reported eye rubbing behaviors using a visual analogue scale (VAS; 0-10) before surgery and at 6-month follow-up.     

CXL affects positively the patients’ subjective perception of the disease and is effective in stabilizing and improving several objective disease severity indicators.

Postoperatively, BCVA improved from 0.213±0.161 to 0.038±0.065 logarithm of the minimum angle of resolution (logMAR; P <.0001). Initially, maximum keratometry (Kmax) and steepest keratometry (K2) increased at 1 month postoperatively and settled to preoperative values at visits conducted at 3 and 6 months following treatment. 

Preoperatively, negative correlations were noted between the KORQ activity limitation score and BCVA, Kmax, K2, flattest keratometry (K1), symmetry index front and higher order aberrations. Postoperative analysis revealed correlations between changes in KORQ scores and the changes in aberrometric parameters, along with reduced eye rubbing behaviors at 6 months (VAS score: 7.658±2.004 to 2.211±1.625; P <.0001). 

The researchers report that “CXL affects positively the patients’ subjective perception of the disease and is effective in stabilizing and improving several objective disease severity indicators. Moreover, the treatment has been proven effective in reducing the eye rubbing behavior, which is a well-known factor contributing to progression of the disease.”

Study limitations include a short duration, small sample size, and single center design.

References:

Ferrini E, Aleo D, Posarelli C, Figus M, Miccoli M, Gabbriellini G. Impact of corneal collagen cross-linking on vision-related quality of life measured with the keratoconus outcomes research questionnaire (KORQ) in patients with keratoconus. Cont Lens Anterior Eye. Published online August 19, 2022. doi:10.1016/j.clae.2022.101746