Background  Keratoprosthesis implantation is an effective way for patients with end-stage corneal blindness to regain sight, and the evaluation of vision-related quality of life (QOL) after surgery has become a research topic for ophthalmologists.

  Objective  To compare the effects of NEI-VFQ-25, SQOL-DVI, VF-QOL in evaluating the QOL of patients with Mihe Kpro.

  Methods   The patients who underwent MIOK keratoprosthesis implantation in our hospital from January 2015 to December 2019 were enrolled, and NEI-VFQ-25, SQOL-DVI, and VF-QOL scales were used to conduct a questionnaire survey to evaluate their QOL after surgery. QOL was compared between the patients with different levels of visual acuity (VA), with VA = 0.3 as the cut-off value.

  Results   A total of 48 patients were enrolled, among whom there were 43 male patients (89.58%) and 5 female patients (10.42%), and their age ranged from 21 to 81 years, with a mean age of 47.08±13.08 years. The total scores of NEI-VFQ-25, VF-QOL, and SQOL-DVI were 50.81±20.86, 68.37±20.02, and 101.38±36.65, respectively, and VF-QOL scale had a significantly higher percentage of mean total score in full score than NEI-VFQ-25 and SQOL-DVI scales (68.37% vs 50.81%/50.69%), suggesting that QOL was at a moderate level for patients who regained sight after MIOK keratoprosthesis implantation. Comparison of the patients with different levels of VA showed that the patients with VA <0.3 had significantly lower scores Md (IQR) of each scale than those with VA ≧0.3 NEI-VFQ-25: 40.00 (28.00-50.25) vs 60.50 (39.75-76.25), P = 0.011; VF-QOL: 68.48 (56.45-84.64) vs 80.52 (63.46-86.53), P = 0.020; SQOL-DVI: 53.75 (38.50-67.00) vs 99.00 (70.25-128.75), P<0.001. As for the evaluation of each dimension, the results of NEI-VFQ-25 showed that the patients with low vision (VA <0.3) tended to have lower scores of overall vision, near activities, long-distance activities, social function, role limitation, and driving function ( P <0.05), with a lack of sensitivity in assessing the impact of vision on mental health ( P >0.05); the results of VF-QOL showed that the patients with low vision tended to have lower scores of subjective vision, peripheral visual field, and activity ability ( P <0.05), with a lack of sensitivity in evaluating the impact of vision on social function, psychology, and mental status ( P >0.05); the results of SQOL-DVI showed that the patients with low vision tended to have lower scores of symptoms and visual function ( P <0.05), with a lack of sensitivity in evaluating the impact of vision on other aspects ( P >0.05).

  Conclusion   QOL is at a moderate level for patients regaining sight after MIOK keratoprosthesis implantation. The three scales can well distinguish the QOL of patients with different levels of vision, and compared with SQOL-DVI and VF-QOL, NIE-VFQ-25 is more suitable for evaluating the QOL of patients after MIOK keratoprosthesis implantation.