The impact of keratoconus treatment with the Athens Protocol (partial topography-guided photorefractive keratectomy combined with higher-fluence corneal collagen cross-linking) on quality of life: a long-term study
Authors Kanellopoulos AJ
Received 24 September 2018
Accepted for publication 4 February 2019
Published 3 May 2019 Volume 2019:13 Pages 795—803
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Colin Mak
Peer reviewer comments 2
Editor who approved publication: Dr Scott Fraser
Anastasios John Kanellopoulos1,2
1Department of Ophthalmology, Laservision.gr, Clinical and Research Eye Institute, Athens, Greece; 2NYU Medical School, Department of Ophthalmology, New York, NY, USA
Purpose: The aim of this study was to evaluate the health-related quality of life (HRQoL) before and after the management of keratoconus (KCN) with Combined Topography-Guided Transepithelial partial photorefractive keratectomy (PRK) and corneal Cross-Linking: the Athens Protocol.
Patients and methods: Thirty-four consecutive patients treated for progressive KCN were selected for retrospective telephone interview and individual questionnaire submission. A disease-specific HRQoL questionnaire was administered before and after the Athens Protocol intervention, using the following administrative questionnaires: National Eye Institute Visual Function Questionnaire (NEI VFQ) 25/39 and IVI-28. The disease grade was ranked according to the Amsler–Krumeich classification (KCN severity). Reliability of collected data was evaluated with Cronbach’s α test.
Results: Patients’ age ranged from 15 to 51 years at the time of the operation. Mean time before the operation during which the questionnaires were administered was 52±6 months. General visual acuity, psychological well-being, and driving ability showed significant improvement. Younger keratoconic patients tend to have more enhanced psychological status and to cope better with difficulties in everyday activities (prior to operation) than older patients.
Conclusion: The Athens Protocol treatment has been proven to be beneficial to patients in a large number of aspects.
Keywords: KCN, Athens Protocol, topography-guided PRK, quality of life, HRQoL questionnaire, NEI VFQ, IVI-28
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