Analysis Of Implant Quality And Quality Of Life In Patients With Bullous Keratopathy After Corneal Transplantation

Objectives:1.To analyze the changes of corneal implant quality and quality of life in patients with bullous keratopathy after corneal transplantation;2.To investigate the related factors affecting the quality of life after corneal transplantation.Methods:1.Patients with bullous keratopathy admitted to Kunming First People’s Hospital from October 2018 to October 2020 were collected.Inclusion criteria:clinically diagnosed as bullous keratopathy;Patients who have agreed to receive corneal transplantation;Able to cooperate and accept preoperative and postoperative examination and follow-up;Can complete the contents of the scale in this study.Exclusion criteria:implant dislocation was not reduced during follow-up;Complicated with other systemic or local diseases that seriously affect quality of life;The researchers judged that the subjects could not comply with the research requirements;2.All subjects gave informed consent and signed informed consent to undergo penetrating keratoplasty or endothelial keratoplasty according to surgical indications,the best corrected visual acuity,intraocular pressure,central corneal thickness,rej ection index and national eye institute-visual function questionnaire were monitored and recorded respectively before and 1 week,1 month,3 months and 6 months after surgery;3.SPSS 25.0 statistical software was used to analyze the corneal implant quality and quality of life of patients with bullous keratopathy after corneal transplantation,the index with mean ± standard deviation(x ± s)describe its average and discrete degree.The corneal implant quality and quality of life data of all patients were grouped preoperatively and at 1 week,1 month,3 months and 6 months after surgery.ANOVA was used for data meeting the normal distribution and homogeneity of variance,while rank sum test was used for data not meeting the requirements.Multiple linear regression was used to analyze the effects of contralateral eye vision,different surgical methods and age on QOL,and P<0.05 was considered statistically significant.Results:1.Twenty-four patients who met the inclusion and exclusion criteria were included.According to the preoperative and postoperative 1 week,l month,3 months,6 months group,an analysis of variance with repeated measurements was performed,the best corrected visual acuity results F=5.246,P=0.001(P<0.05),the preoperative and postoperative corneal transplantation better vision correction difference was statistically significant.The results of corneal central thickness showed that F=12.872,P=0.000(P<0.05),the difference of corneal central thickness before and after corneal transplantation was statistically significant.The results of intraocular pressure showed that F=1.062,P=0.379(P>0.05).There was no significant difference in intraocular pressure between preoperative and postoperative corneal transplantation.The rejection index results showed that F=1.787,P=0.155(P>0.05).There was no statistical significance in the rejection index between preoperative and postoperative corneal transplantation;2.An analysis of ANOVA was performed,the total score of quality of life,total visual acuity,eye pain,near movement,distance movement,social movement,mental state and role limitation of 8 dimensions before and after corneal transplantation were P<0.05,and the differences between preoperative and postoperative corneal transplantation were statistically significant.There was no statistically significant difference between preoperative and postoperative corneal transplantation in overall health,peripheral vision,color vision and dependence,P>0.05;3.According to the contralateral eye sight,different operation modes and different age groups,using multiple linear regression analysis,a quality of life scores as the dependent variable,the independent variables are respectively the contralateral eye eyesight,different ways of operation and the age,the results show that after corneal transplantation survival quality score was positively related with the contralateral eye eyesight(regression coefficient=19.802,P=0.001),no obvious correlation with age,and by different surgical procedures(P>0.005).Conclusions:1.The best corrected visual acuity after corneal transplantation was improved,the corneal edema was significantly reduced,and the quality of life was significantly improved,keratoplasty is the effect way of bullous keratopathy;2.The quality of life after corneal transplantation was positively correlated with the visual acuity of the contralateral eye.