Patient satisfaction after corneal transplantation.

Abstract

To determine the relationship between objective and subjective outcome measures and patient satisfaction after corneal transplantation. Data were collected for 184 patients who underwent a corneal transplantation between 1 and 5 years ago. Only patients with the diagnosis of bullous keratopathy, endothelial decompensation (or Fuchs dystrophy), nonherpetic keratitis, and keratoconus were included. Objective treatment outcome measures, such as clarity of the graft and visual acuity in the grafted eye, were collected prospectively. Visual acuity of the other eye was collected retrospectively by chart review. Subjective outcome measures were derived from a retrospective survey. In addition to assessment of patient satisfaction, the survey provided information regarding subjective outcome measures, such as visual functioning and quality of life. The response rate was 86%. Generally, patients indicated that they were satisfied with the results of the transplantation. Age was negatively related to satisfaction, with older patients being less satisfied. On average, patients with keratoconus were most satisfied. Subjective outcome measures explained 57% of the variance in patient satisfaction, whereas objective factors explained 12%. Receipt of patient education during treatment was the best predictor. Other important variables were quality of life and visual functioning. In general, corneal transplantation had a positive effect on objective and subjective outcome measures. Patient satisfaction was better predicted by subjective outcomes than by objective outcomes. Patient education, in particular, proved to be a crucial factor. Objective outcome measures appeared to have a more indirect influence on patient satisfaction.