Wait Time, Vision and Health Problems in Adults Expecting a Corneal Transplant or Cataract Surgery at Maisonneuve-Rosemont Hospital in Montreal, Canada

Abstract

Purpose: : Governments of Canada have made efforts to reduce wait time for cataract surgery. Wait time for corneal transplantation still is a problem in Montreal. Our goal was to compare wait time, vision and health problems in adults expecting a corneal transplant (penetrating keratoplasty - PK or Descemet's Stripping Automated Endothelial Keratoplasty - DSAEK) to patients waiting for cataract surgery and to adults with good vision.

Methods: : Cross-sectional, case-control, single institution study. Consecutive candidates waiting for DSAEK or PK as of January 31, 2009 were age/gender frequency matched to controls waiting for cataract surgery with the same cornea surgeons and to controls not awaiting eye surgery, (four groups, n=25 in each group). Dates of evaluation and entry onto hospital waiting list were recorded. Visual acuity, visual symptoms, and satisfaction with vision and wait time were evaluated. Patients also completed interviewer-administered questionnaires including the VF-14 and the Geriatric Depression scales.

Results: : Mean age was 72 years, 2/3 were females and 94% Caucasian. The average wait time was significantly longer for transplantation surgeries: 20 ± 15 months for DSAEK, 20 ± 17 months for PK, compared to 4 ± 4 months for cataract surgery (P< 0.001). Graft candidates felt their wait time should be on average 8 ± 5 months and 58% found their wait time unacceptable compared to 17% of cataract surgery patients (P=0.003). Both DSAEK and PK patients had worse VF-14 scores than cataract surgery patients (P<0.001 and P=0.012). PK patients had worse depression scores than control patients (P<0.010).

Conclusions: : Patients with long wait times for corneal transplantation have lower visual function and depression scores, and are dissatisfied with wait time. The Province of Quebec has recently started to address the issue.

Keywords: clinical (human) or epidemiologic studies: health care delivery/economics/manpower • transplantation • quality of life