Balparda Kepa, Herrera-Chalarca Tatiana, Silva-Quintero Laura Andrea, Torres-Soto Sneider Alexander, Segura-Muñoz Laura, Vanegas-Ramirez Claudia Marcela
Department of Cornea and Refractive Surgery, Black Mammoth Surgical, Medellín, Colombia.
Predoctoral Research Group, Universidad de Valladolid, Valladolid, Spain.
Clin Ophthalmol. 2020 Jun 30;14:1839-1845. doi: 10.2147/OPTH.S261785. eCollection 2020.
Keratoconus is a disease characterized by progressive corneal distortion and quality of vision. So far, no study using disease-specific scales has evaluated whether different stages of the disease correlate with higher quality of life (QoL) compromise.
A total of 114 patients with a confirmed diagnosis of Keratoconus were included in this retrospective study. All patients underwent a clinical and a Pentacam evaluation. They were also administered the "Keratoconus End-Points Assessment Questionnaire" (KEPAQ). Belin ABCD criteria were used for Keratoconus classification. "Better eye" was defined as the eye with the lowest maximum keratometry value. Spearman Rank Order Correlation was used to determine the correlation between the different Belin criteria and the KEPAQ scores in both subscales.
Mean age was 28.13 ± 11.57 years, with 39.47% of patients being male. Mean score for the KEPAQ-E was 2.33 ± 3.40 Logit, while for the KEPAQ-F, it was 1.85 ± 3.61 Logit. Criteria A (anterior elevation), B (posterior elevation) and D (visual acuity) in the worse eye correlated significantly with a greater decrease in QoL ( < 0.05 for all correlations). No correlation could be found regarding the better eye.
A greater corneal distortion in the worse eye, as determined by Belin ABCD, is associated with a greater decrease in patient's QoL. Surgical improvement of the worse eye should probably be performed before surgery of the better eye, as it may provide a better response regarding the quality of life improvement.
圆锥角膜是一种以角膜进行性变形和视力下降为特征的疾病。到目前为止，尚无使用疾病特异性量表的研究评估该疾病的不同阶段是否与更高的生活质量（QoL）受损相关。
本回顾性研究共纳入114例确诊为圆锥角膜的患者。所有患者均接受了临床和Pentacam评估。他们还被给予了“圆锥角膜终点评估问卷”（KEPAQ）。使用贝林ABCD标准进行圆锥角膜分类。“较好眼”定义为最大角膜曲率值最低的眼。采用Spearman等级相关分析来确定不同贝林标准与两个子量表中KEPAQ评分之间的相关性。
平均年龄为28.13±11.57岁，39.47%的患者为男性。KEPAQ-E的平均评分为2.33±3.40 Logit，而KEPAQ-F的平均评分为1.85±3.61 Logit。较差眼中的标准A（前表面高度）、B（后表面高度）和D（视力）与生活质量的更大下降显著相关（所有相关性P<0.05）。在较好眼中未发现相关性。
根据贝林ABCD标准，较差眼中更大的角膜变形与患者生活质量的更大下降相关。较差眼的手术改善可能应在较好眼手术之前进行，因为这可能在改善生活质量方面提供更好的效果。
