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Clinical science
Evaluation of the impact of intracorneal ring segments implantation on the quality of life of patients with keratoconus using the NEI-RQL (National Eye Institute Refractive Error Quality of life) instrument
  1. J de Freitas Santos Paranhos,
  2. M P Ávila,
  3. A Paranhos Jr,
  4. P Schor
  1. Federal University of São Paulo, Brazil
  1. Correspondence to Dr J F S Paranhos, Hospital da Visão, Empresa Particular, Rua 38, no 300, Setor Marista, 74150250, Goiania, GO, Brazil; ju.fsp{at}


Background/aims: A prospective study evaluating the impact of intracorneal ring segment (ICRS) implantation on the quality of life of patients with keratoconus using the NEI-RQL (National Eye Institute Refractive Error Quality of Life) instrument.

Methods: Sixty-nine eyes of 42 keratoconus patients were implanted with the Keraring. All patients self-administered the NEI-RQL before and 4½ to 8 months after surgery. The results were evaluated and analysed, along with best-corrected visual acuity (BCVA), refraction, contrast sensitivity, corneal topography and aberrometry preoperatively and 3 months postoperatively.

Results: There was a significant improvement in all NEI-RQL scales and the overall scale. “Clarity of vision,” “far vision,” “near vision,” “activity limitations,” “appearance” and “satisfaction with correction” had the greatest improvement, ranging from 25 to 50 preoperatively to 80 to 90 after surgery. Best spectacle-corrected visual acuity and binocular BCVA improved significantly, and there was a significant decrease in keratometric values, from 50.22 dioptres preoperatively to 46.27 dioptres postoperatively. Contrast sensitivity function improved postoperatively, especially at the frequency of 6 cpd. Low-order root mean square (RMS) improved after surgery, but high-order RMS did not.

Conclusion: ICRS implantation not only improves the quantitative metrics such as visual acuity and refraction, but also has a positive impact on patients’ quality of life.

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  • Competing interests None.

  • Ethics approval Ethics approval was provided by the ethical committees of the Federal University of Goiás and the Federal University of São Paulo.

  • Patient consent Obtained.

  • Provenance and Peer review Not commissioned; externally peer reviewed.