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Both Subjective Emotional Distress and Visual Handicap Correlate with Belin ABCD Classification in the Worse Eye as Measured with the “Keratoconus End-Points Assessment Questionnaire” (KEPAQ)

Authors Balparda K, Herrera-Chalarca T, Silva-Quintero LA, Torres-Soto SA, Segura-Muñoz L, Vanegas-Ramirez CM

Received 8 May 2020

Accepted for publication 10 June 2020

Published 30 June 2020 Volume 2020:14 Pages 1839—1845


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Scott Fraser

Kepa Balparda,1,2 Tatiana Herrera-Chalarca,3 Laura Andrea Silva-Quintero,4 Sneider Alexander Torres-Soto,4 Laura Segura-Muñoz,5 Claudia Marcela Vanegas-Ramirez6

1Department of Cornea and Refractive Surgery, Black Mammoth Surgical, Medellín, Colombia; 2Predoctoral Research Group, Universidad de Valladolid, Valladolid, Spain; 3Department of Clinical Research, Black Mammoth Surgical, Medellín, Colombia; 4Medicarte, Medellín, Colombia; 5School of Medicine, Universidad Pontificia Bolivariana, Medellín, Colombia; 6Department of Ophthalmology, Universidad Pontificia Bolivariana, Medellín, Colombia

Correspondence: Kepa Balparda Email

Background: 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.
Methods: 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.
Results: 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 (p < 0.05 for all correlations). No correlation could be found regarding the better eye.
Conclusion: 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.

Keywords: Keratoconus, quality of life, vision ocular

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