Wait Times for Corneal Transplant in Quebec, Canada: 2000-2007

Abstract

Purpose: : To estimate wait times for corneal transplant in the province of Quebec, Canada and to determine whether visual acuity worsens while on the wait list.

Methods: : Data on all patients who were put on the wait list for a corneal transplant at Maisonneuve-Rosemont Hospital (HMR) (Montreal, Quebec) from 2000-2007 were abstracted from hospital medical charts and Eye Bank of Quebec records. Data on patient age and gender, date of entry onto transplant wait list, date of surgery or exit from list, reason of exit from list, and visual acuity when put on the waitlist and at the time of surgery were recorded. Kaplan-Meier survival analysis was used to estimate the median wait time. For those eyes that did not have surgery, wait times were censored at the date of exit from the wait list or else at the end of follow-up on September 30, 2008.

Results: : 483 eyes from 397 individuals were placed on the corneal transplant wait list at HMR from 2000-2007. Of these 483 eyes, 289 (60%) had a transplant, 29 refused the transplant (6%), 11 died (2%), and 5 (1%) no longer qualified for a transplant. The other 149 eyes were still waiting for a transplant as of September 30, 2008 (31%). The mean visual acuity in the surgical eye was 1.3 logMAR (SD=0.67) or 20/400. Using Kaplan-Meier survival analysis, the median wait time was 1.97 years. Patient age and gender were not related to wait time, although there were large differences in the median wait times for the 4 corneal specialists at HMR (logrank test, p<0.01). Of those who had a transplant (n=289), 39% lost 2 or more lines of visual acuity while waiting.Significance: People waiting for corneal transplant have very poor vision in their surgical eye and often must wait for many months or even years. It is important to monitor wait times for corneal transplant so that measures can be taken to improve wait times and reduce patient burden.

Keywords: cornea: clinical science • clinical (human) or epidemiologic studies: health care delivery/economics/manpower