Vision-Related Impact of Corneal Transplantation on Quality of Life in an Elderly Patient Population
Narrative Responses:
Purpose
To assess the vision-related quality of life (QOL) and satisfaction of elderly patients who received corneal transplants
Methods
This is a single institution, retrospective, observational, cross-sectional study. Survey data using a modified Visual Function Index (VF-14) were collected from 175 patients (age≥65) of 414 eligible who underwent corneal transplantation between 2008-2010 at the Wilmer Eye Institute. The survey assessed visual functionality and QOL. Surgeries included Penetrating Keratoplasty (PKP), Descemet's Stripping Automated Endothelial Keratoplasty (DSAEK), and Keratoprosthesis (KP). Clinical data, including age and initial and follow-up visual acuity, were collected. QOL survey responses were compared with clinical findings to assess for differences between objective and subjective visual functioning.
Results
172 patients were reviewed for surgery type. 50% (86/172) patients had follow up data. Controlling for age, procedure, and baseline visual acuity, patients treated by PKP (p=0.002) or KP (p=0.019) were found to have poorer QOL scores than those treated with DSAEK. Older patients reported that their QOL directly improved after surgery (p=0.005). Lower baseline visual acuity was associated with worse QOL (p<0.001). When asked directly about QOL, patients with poor follow-up vision reported no change in QOL (p=0.046).
Conclusion
The type of transplant surgery (DSAEK), older recipient age, and higher baseline visual acuity appear to be associated with improved QOL in this study. Vision at follow-up is not associated with QOL decline. Based on these findings, transplant surgery should be considered for elderly patients.