Creation of priority criteria for corneal transplantation and analysis of factors associated with surgery following implementation.

PURPOSE: We sought to test the effectiveness and application of a system for prioritizing corneal disease patients for corneal transplantation.
METHODS: All patients wait-listed for corneal transplantation in British Columbia in April 1995 were followed for 10 months to determine whether they received surgery and to assess the application of recently introduced priority criteria.
RESULTS: The factors that determined whether a patient had surgery were as follows: having vision in one eye only, being female, having progressive disease, and experiencing pain. The surgeon involved was also a factor. Overall, the priority system did not adequately predict who had surgery and who did not have surgery.
CONCLUSIONS: The priority system needs to be re-structured to reduce the contribution of months waited and to more adequately take into account patient need. Furthermore, its application by individual surgeons needs to be strengthened.