IPoster: Vision-Related Quality of Life in Keratoconus: Scleral versus Corneal Gas Permeable Lens Correction

Purpose: Identify differences in vision-related quality of life (VRQoL) for keratoconic (KCN) persons with scleral gas permeable (SGP) correction as compared to corneal gas permeable (CGP) correction. Contact lens comfort and handling were also assessed.

Methods: Three geographically diverse locations administered surveys to KCN subjects who habitually wore SGP or CGP lenses in the absence of corneal surgery, other conditions impacting vision, or piggyback lens systems. Severity classification of KCN was based on simulated keratometry using the Collaborative Longitudinal Evaluation of Keratoconus study group’s grading scheme. Outcome measures included the National Eye Institute Visual Function Questionnaire-25 (NEI-VFQ-25) and questions on lens comfort and handling. Comparisons were assessed using one-tailed Wilcoxon tests.

Results:  Thirty-five KCN subjects were included in the analysis. There was no significant difference in overall NEI-VFQ-25 scores between SGP and CGP groups (p=0.18). The greatest differences in NEI-VFQ-25 subscale scores between SGP and CGP wearers were found for the dependency upon other persons (p=0.01), general vision (p=0.07) and driving (p=0.07) subscales, with SGP scoring better in all three subscales. No statistically significant differences were found between SGP and CGP for the overall score or the subscale scores when subjects were grouped based on KCN severity (all p > 0.05).  End of the day comfort was significantly better for SGP wearers (p=0.009). Difficulty with lens application and removal was similar between groups (p=0.30).

Conclusion(s):  KCN persons wearing SGP and CGP have similar VRQoL. The benefits of  superior comfort and vision with SGP lenses may not extend to superior VRQoL in keratoconus. Future cross-over studies may further elucidate differences in VRQoL and help optometrists envisage contact lens options that optimize VRQoL in this important population. 

Chandra V Mickles, OD, MS, FAAO

Dr. Mickles is an Associate Professor at Nova Southeastern University College of Optometry. 
She received her Bachelor of Science degree with honors from the University of Miami and her Doctor of Optometry degree from the State University of New York College of Optometry graduating in the top ten of her 
class. Her Master of Science in Vision Science and residency training in Cornea and Contact Lenses were completed at the University of Alabama at Birmingham School of Optometry. Additionally, Dr. Mickles completed a two year Veterans Affairs Optometric Research Fellowship at the Birmingham VA Medical Center. 

Dr. Mickles has lectured and published in the areas of contact lenses and ocular surface disease.