Patient subjective visual function after corneal collagen crosslinking for keratoconus and corneal ectasia

J Cataract Refract Surg. 2012 Apr;38(4):615-9. doi: 10.1016/j.jcrs.2011.11.029. Epub 2012 Feb 18.

Abstract

Purpose: To assess subjective visual function after corneal collagen crosslinking (CXL).

Setting: Cornea and refractive surgery subspecialty practice.

Design: Prospective randomized controlled clinical trial.

Methods: Patients completed a subjective questionnaire regarding visual symptoms administered preoperatively and 1 year after CXL. Patients ranked self-reported symptoms of photophobia, difficulty night driving, difficulty reading, diplopia, fluctuations in vision, glare, halo, starburst, dryness, pain, and foreign-body sensation on a scale from 1 to 5. Possible associations of symptoms with changes in corrected distance visual acuity (CDVA) and maximum keratometry were also analyzed.

Results: One hundred seven eyes of 76 patients had CXL for keratoconus (n = 71) or ectasia (n = 36). The mean preoperative to 1-year postoperative changes in night driving (3.2 ± 1.5 [SD] to 2.8 ± 1.5), difficulty reading (3.1 ± 1.5 to 2.9 ± 1.3), diplopia (2.5 ± 1.3 to 2.1 ± 1.2), glare (3.1 ± 1.4 to 2.7 ± 1.2), halo (2.9 ± 1.4 to 2.5 ± 1.3), starbursts (2.6 ± 1.5 to 2.4 ± 1.4), and foreign-body sensation (1.8 ± 1.1 to 1.6 ± 0.9) were statistically significant. There were no associations between the change in any symptom and changes in CDVA. There was a weak association between the change in night driving, pain, and foreign-body sensations and the change in maximum keratometry.

Conclusions: After CXL, patients noted subjective improvement in visual symptoms, specifically night driving, difficulty reading, diplopia, glare, halo, starbursts, and foreign-body sensation. These subjective outcomes corroborate quantitative clinical improvements seen after CXL.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Automobile Driving
  • Collagen / metabolism*
  • Corneal Stroma / metabolism*
  • Cross-Linking Reagents / metabolism*
  • Dilatation, Pathologic / drug therapy
  • Dilatation, Pathologic / metabolism
  • Diplopia / physiopathology
  • Glare
  • Humans
  • Keratoconus / drug therapy*
  • Keratoconus / metabolism
  • Photosensitizing Agents / therapeutic use
  • Prospective Studies
  • Reading
  • Refraction, Ocular / physiology*
  • Riboflavin / therapeutic use
  • Surveys and Questionnaires
  • Treatment Outcome
  • Ultraviolet Rays
  • Vision Disorders / physiopathology
  • Visual Acuity / physiology*

Substances

  • Cross-Linking Reagents
  • Photosensitizing Agents
  • Collagen
  • Riboflavin