Articles about Eye Health and Disease 2003
Assessment of Visual Function after Corneal Transplantation: the quality of life and psychometric assessment after corneal transplantation
(From Flavia Mendes, et al., Ophthalmology (2003) 110: 1082-1088.)
Many patients with successful corneal transplants (grafts) have poor vision postoperatively. This study evaluated changes in vision-related quality of life after penetrating keratoplasty (PKP – Corneal Transplant Surgery).
Penetrating keratoplasty candidates from the university-affiliated ophthalmology clinics of four participating centers were enrolled and followed up prospectively. The PK-VFQ was used, which is a questionnaire evaluating vision related quality of life issues, and activities of daily living related to vision. It is a modified version of the Visual Function Index-14, which has been used to evaluate visual function after other procedures such as cataract surgery. The questionnaire, combined with clinical examinations, was given before, and at 6 and 12 months after PKP surgery. Statistical analysis of the change in PK-VFQ scores was performed.
Enrolled in the study were 74 corneal transplant eyes in 67 patients aged 23 to 91 years (average, 61) years that were followed up for at least 6 months. Indications for surgery included
Results: The average preoperative visual acuity was 20/200 in the graft candidate and 20/30 in the best eye. Average best-corrected postoperative visual acuity in the operated eyes was 20/60 at 6 months. PK-VFQ scores improved at 6 months in 79% by an average of 13.0 points (range, -16.7 to 67.5). Improvement in PK-VFQ scores was associated with younger age, poorer preoperative visual acuity in the best eye, and postoperative contact lens use, but not with postoperative acuity in the grafted eye. Postoperatively, 80% of patients were moderately to very satisfied with their vision, and 97% of patients stated they would have the surgery again. Improvement in visual function is inversely associated with visual acuity in the better-seeing eye but does not correlate with the postoperative acuity in the grafted eye. Although most corneal transplants are done in only one eye in the setting of good visual acuity in the other eye, for the majority of patients visual function improves after PK.
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