Quality of Life Enhancement After Penetrating Keratoplasty in Keratoconus: A Vision-Related Functional Perspective

Abstract

Background/Objectives: Keratoconus (KC) is a bilateral asymmetric corneal ectasia characterized by progressive corneal thinning, irregular astigmatism, and impaired visual acuity. The National Eye Institute (NEI) developed the Visual Function Questionnaire (VFQ-25) to assess the impact of visual impairment on quality of life. This study aimed to evaluate the effect of penetrating keratoplasty (PKP) on quality of life and visual acuity in KC patients one year postoperatively. Methods: A retrospective study was conducted between January 2018 and December 2022 at the Ophthalmology Department of Saint Barbara Hospital, Trauma Center, Sosnowiec, Poland. A total of 71 patients (86 eyes) diagnosed with KC underwent PKP. The VFQ-25 questionnaire and visual acuity measurements were assessed preoperatively and one year postoperatively. Results: The study cohort included 71 patients (20 females, 28.17%; 51 males, 71.83%). Preoperative visual acuity ranged from less than 0.05 on the Snellen chart to 0.5. Postoperatively, visual acuity improved to a range of 0.1-1.0. A visual acuity of 1.0 was achieved in 21 eyes (24.42%; 5 females, 24%; 16 males, 76%), with a statistically significant improvement (p < 0.01). The mean VFQ-25 composite score increased from 57.96 (±17.58) preoperatively to 81.42 (±14.66) postoperatively (p < 0.001). Domains with the lowest preoperative scores were "role difficulties," "general vision," and "mental health," while "color vision" scored highest. Conclusions: PKP significantly enhances both objective visual acuity and subjective quality of life in KC patients, as reflected in VFQ-25 questionnaire outcomes.

Keywords: keratoconus; penetrating keratoplasty; quality of life; retrospective studies; visual acuity.