Abstract
Abstract: :
Purpose:Many patients with successful (clear) corneal grafts still have poor visual function postoperatively due to irregular astigmatism or other complications. This prospective multicenter study was designed to evaluate changes in vision-related quality of life after penetrating keratoplasty (PK) so as to determine to what extent patients benefit functionally from PK. Methods:Patients scheduled for PK at four participating centers were invited to enroll in this study. We used a modified version of the Visual Function Index-14 (VF-14) questionnaire combined with clinical examinations before surgery and at 6 and 12 months of follow-up. Linear regression models were used to examine predictors of improvement in visual function. Preliminary analyses are presented herein. Results:We studied 74 grafts in 71 eyes of 67 patients who completed their follow-up visual function questionnaires (VFQ). Patients were aged 23 to 91 (mean 61) years, and 61% were female. The main indications for surgery were: bullous keratopathy (32%), corneal scarring (18%), keratoconus (17%), corneal dystrophy (15%), and regrafts (12%), and other (6%). Median preoperative VA was 20/200 in the eyes undergoing surgery and 20/30 in the best seeing eye. Median best-corrected VA in the eyes with PK was 20/60 at 6 months and 20/50 at 12 months. VFQ scores improved at 6 months in 79%, by an average of 13.0 points (range: 16.7 points worse to 67.5 points better). Improvement in VFQ scores was significantly associated with poorer preoperative VA in the better seeing eye (p<0.0001), and modestly with improved postoperative VA in the operated eye (p=0.11). Increase in age was associated with a lower VFQ score (p=0.066). 80% of patients were 'moderately' to 'very satisfied' with their overall vision after both 6 and 12 months of follow-up. Overall, 97% of patients stated that they would have the surgery again based on their experience. Conclusion:The present study indicates that a large majority of patients experience improved visual function after PK. Improvement in overall visual function is inversely correlated with visual potential in the contralateral eye and correlated significantly with improvements in postoperative visual acuity in the operated eye.
Keywords: 369 cornea: clinical science • 607 transplantation • 620 visual acuity