Abstract
Purpose :
The purpose was to investigate predictors of vision and health-related quality of life (QOL) one year after corneal transplantation.
Methods :
Patients (N=233, mean age 68) were recruited from eleven hospitals across the Netherlands. In this longitudinal prospective cohort study, patients were assessed 1 month before and 3, 6 and 12 months after corneal transplantation using the Low Vision QOL questionnaire (LVQOL) and the EuroQOL 5 Dimensions questionnaire (EQ-5D). Demographic and clinical characteristics were considered as potential predictors. Linear mixed models were used to analyse the LVQOL, and generalized estimating equations for dichotomized EQ-5D scores due to skewed data.
Results :
LVQOL-scores improved over time (b=13.4; 95%CI 9.0 to 17.8 at 12 months). Worse baseline logMAR visual acuity of the best eye predicted worse LVQOL-scores (b=-13.8; 95%CI -19.1 to -8.5). Worse baseline scores on the Eye Complaint Questionnaire and the Dry Eye Questionnaire (DEQ) predicted worse LVQOL-scores (respectively b=-0.9; 95%CI -1.1 to -0.7; b=-1.2; 95%CI -1.2 to -0.7). The odds of having a perfect EQ-5D score did not change over time, however, the odds of having a perfect score were lower when having comorbidity (odds ratio, OR 0.41; 95%CI 0.3 to 0.6) or at higher age (OR 0.97; 95%CI 0.94 to 0.99 at 12 months). Patients with worse DEQ-scores had a lower odds of having a perfect EQ-5D over time (ORs between 0.95 and 0.97 and 95%CIs between 0.91 and 1.0). Finally, people eligible for lamellar keratoplasty had a higher odds of having a perfect score compared to penetrating keratoplasty (OR 2.6; 95%CI 1.5 to 4.4).
Conclusions :
Vision-related QOL improved considerably over time with a linear upward trend, which means that the corneal transplantation seems to be very effective and has an important positive impact on daily life. Low visual acuity and eye complaints related to corneal disease were important predictors of vision-related QOL. Long term follow-up data will show whether this upward trend will continue. Although there were some significant predictors, effects of transplantation for health-related QOL were less outspoken. However, many patients had a (near) perfect score at baseline, hence no room for improvement. The results of this study may contribute to realistic communications about expectations of corneal transplantation and to recommendations for patient-centered care.
This is a 2021 ARVO Annual Meeting abstract.