Long-term mental health outcomes after corneal transplantation and potential predictors: A multicentre prospective cohort study

E B M Elsman; H P A Van der Aa; N E Billingy; C Nieuwendaal; R P L Wisse; R J Wijdh; M L Tang; B T H Van Dooren; S Nobacht; R M M A Nuijts; G H M B Van Rens; R M A Van Nispen

doi:10.1111/opo.13432

Long-term mental health outcomes after corneal transplantation and potential predictors: A multicentre prospective cohort study

E B M Elsman^*, H P A Van der Aa, N E Billingy, C Nieuwendaal, R P L Wisse, R J Wijdh, M L Tang, B T H Van Dooren, S Nobacht, R M M A Nuijts, G H M B Van Rens, R M A Van Nispen

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

Introduction: To evaluate the long-term effect of corneal transplantation on mental health outcomes and to assess potential predictors of these outcomes. Methods: For this multicentre prospective cohort study, patients awaiting corneal transplantation were recruited from 11 (academic) hospitals and eye clinics in the Netherlands. Participants (n = 238) completed the Centre for Epidemiological Studies Depression scale (CES-D), the Hospital Anxiety and Depression Scale-Anxiety subscale (HADS-A) and the Dutch ICF Activity Inventory Emotional Health subscale (DAI-EH) and Fatigue subscale (DAI-F) 1 month prior and 3, 6, 12 and 24 months after corneal transplantation. Sociodemographic and clinical characteristics, as well as coping styles as measured with the Utrecht Coping List, were considered as potential predictors for mental health outcomes (depression, anxiety, emotional health problems and fatigue). Linear mixed models were used to analyse and predict symptoms of depression, anxiety, emotional health problems and fatigue over time. Results: Scores on the CES-D and HADS-A improved significantly from baseline to 24-months (mean scores CES-D: 8.6 vs. 7.7, p = 0.03; mean scores HADS-A: 3.7 vs. 3.2, p = 0.002). Scores on the DAI-EH and DAI-F also improved significantly from baseline to 24-months (mean scores DAI-EH: 10.7 vs. 7.5, p < 0.001; mean scores DAI-F: 17.4 vs. 11.3, p < 0.001). Male sex and Fuchs' dystrophy were important predictors of better mental health outcomes, whereas comorbidity, (dry) eye complaints and a passive reacting coping style were important predictors of worse mental health outcomes. Conclusion: Corneal transplantation had a positive impact on mental health outcomes and important predictors were identified. This study may improve the understanding of patients and eyecare practitioners about the effects of corneal transplantation, leading to realistic communication about corneal transplantation expectations.

Original language	English
Pages (from-to)	340-351
Number of pages	12
Journal	Ophthalmic and Physiological Optics
Volume	45
Issue number	2
Early online date	11 Dec 2024
DOIs	https://doi.org/10.1111/opo.13432
Publication status	Published - Mar 2025

Keywords

anxiety
corneal transplantation
depression
fatigue
mental health
patient-reported outcomes

Access to Document

10.1111/opo.13432Licence: CC BY

Cite this

Elsman, E. B. M., Van der Aa, H. P. A., Billingy, N. E., Nieuwendaal, C., Wisse, R. P. L., Wijdh, R. J., Tang, M. L., Van Dooren, B. T. H., Nobacht, S., Nuijts, R. M. M. A., Van Rens, G. H. M. B., & Van Nispen, R. M. A. (2025). Long-term mental health outcomes after corneal transplantation and potential predictors: A multicentre prospective cohort study. Ophthalmic and Physiological Optics, 45(2), 340-351. https://doi.org/10.1111/opo.13432

@article{87c99b95bc9c44e5b4908d24f5d49532,

title = "Long-term mental health outcomes after corneal transplantation and potential predictors: A multicentre prospective cohort study",

abstract = "Introduction: To evaluate the long-term effect of corneal transplantation on mental health outcomes and to assess potential predictors of these outcomes. Methods: For this multicentre prospective cohort study, patients awaiting corneal transplantation were recruited from 11 (academic) hospitals and eye clinics in the Netherlands. Participants (n = 238) completed the Centre for Epidemiological Studies Depression scale (CES-D), the Hospital Anxiety and Depression Scale-Anxiety subscale (HADS-A) and the Dutch ICF Activity Inventory Emotional Health subscale (DAI-EH) and Fatigue subscale (DAI-F) 1 month prior and 3, 6, 12 and 24 months after corneal transplantation. Sociodemographic and clinical characteristics, as well as coping styles as measured with the Utrecht Coping List, were considered as potential predictors for mental health outcomes (depression, anxiety, emotional health problems and fatigue). Linear mixed models were used to analyse and predict symptoms of depression, anxiety, emotional health problems and fatigue over time. Results: Scores on the CES-D and HADS-A improved significantly from baseline to 24-months (mean scores CES-D: 8.6 vs. 7.7, p = 0.03; mean scores HADS-A: 3.7 vs. 3.2, p = 0.002). Scores on the DAI-EH and DAI-F also improved significantly from baseline to 24-months (mean scores DAI-EH: 10.7 vs. 7.5, p < 0.001; mean scores DAI-F: 17.4 vs. 11.3, p < 0.001). Male sex and Fuchs' dystrophy were important predictors of better mental health outcomes, whereas comorbidity, (dry) eye complaints and a passive reacting coping style were important predictors of worse mental health outcomes. Conclusion: Corneal transplantation had a positive impact on mental health outcomes and important predictors were identified. This study may improve the understanding of patients and eyecare practitioners about the effects of corneal transplantation, leading to realistic communication about corneal transplantation expectations.",

keywords = "anxiety, corneal transplantation, depression, fatigue, mental health, patient-reported outcomes",

author = "Elsman, {E B M} and {Van der Aa}, {H P A} and Billingy, {N E} and C Nieuwendaal and Wisse, {R P L} and Wijdh, {R J} and Tang, {M L} and {Van Dooren}, {B T H} and S Nobacht and Nuijts, {R M M A} and {Van Rens}, {G H M B} and {Van Nispen}, {R M A}",

year = "2025",

month = mar,

doi = "10.1111/opo.13432",

language = "English",

volume = "45",

pages = "340--351",

journal = "Ophthalmic and Physiological Optics",

issn = "0275-5408",

publisher = "Wiley-Blackwell",

number = "2",

}

Elsman, EBM, Van der Aa, HPA, Billingy, NE, Nieuwendaal, C, Wisse, RPL, Wijdh, RJ, Tang, ML, Van Dooren, BTH, Nobacht, S, Nuijts, RMMA, Van Rens, GHMB & Van Nispen, RMA 2025, 'Long-term mental health outcomes after corneal transplantation and potential predictors: A multicentre prospective cohort study', Ophthalmic and Physiological Optics, vol. 45, no. 2, pp. 340-351. https://doi.org/10.1111/opo.13432

TY - JOUR

T1 - Long-term mental health outcomes after corneal transplantation and potential predictors

T2 - A multicentre prospective cohort study

AU - Elsman, E B M

AU - Van der Aa, H P A

AU - Billingy, N E

AU - Nieuwendaal, C

AU - Wisse, R P L

AU - Wijdh, R J

AU - Tang, M L

AU - Van Dooren, B T H

AU - Nobacht, S

AU - Nuijts, R M M A

AU - Van Rens, G H M B

AU - Van Nispen, R M A

PY - 2025/3

Y1 - 2025/3

N2 - Introduction: To evaluate the long-term effect of corneal transplantation on mental health outcomes and to assess potential predictors of these outcomes. Methods: For this multicentre prospective cohort study, patients awaiting corneal transplantation were recruited from 11 (academic) hospitals and eye clinics in the Netherlands. Participants (n = 238) completed the Centre for Epidemiological Studies Depression scale (CES-D), the Hospital Anxiety and Depression Scale-Anxiety subscale (HADS-A) and the Dutch ICF Activity Inventory Emotional Health subscale (DAI-EH) and Fatigue subscale (DAI-F) 1 month prior and 3, 6, 12 and 24 months after corneal transplantation. Sociodemographic and clinical characteristics, as well as coping styles as measured with the Utrecht Coping List, were considered as potential predictors for mental health outcomes (depression, anxiety, emotional health problems and fatigue). Linear mixed models were used to analyse and predict symptoms of depression, anxiety, emotional health problems and fatigue over time. Results: Scores on the CES-D and HADS-A improved significantly from baseline to 24-months (mean scores CES-D: 8.6 vs. 7.7, p = 0.03; mean scores HADS-A: 3.7 vs. 3.2, p = 0.002). Scores on the DAI-EH and DAI-F also improved significantly from baseline to 24-months (mean scores DAI-EH: 10.7 vs. 7.5, p < 0.001; mean scores DAI-F: 17.4 vs. 11.3, p < 0.001). Male sex and Fuchs' dystrophy were important predictors of better mental health outcomes, whereas comorbidity, (dry) eye complaints and a passive reacting coping style were important predictors of worse mental health outcomes. Conclusion: Corneal transplantation had a positive impact on mental health outcomes and important predictors were identified. This study may improve the understanding of patients and eyecare practitioners about the effects of corneal transplantation, leading to realistic communication about corneal transplantation expectations.

AB - Introduction: To evaluate the long-term effect of corneal transplantation on mental health outcomes and to assess potential predictors of these outcomes. Methods: For this multicentre prospective cohort study, patients awaiting corneal transplantation were recruited from 11 (academic) hospitals and eye clinics in the Netherlands. Participants (n = 238) completed the Centre for Epidemiological Studies Depression scale (CES-D), the Hospital Anxiety and Depression Scale-Anxiety subscale (HADS-A) and the Dutch ICF Activity Inventory Emotional Health subscale (DAI-EH) and Fatigue subscale (DAI-F) 1 month prior and 3, 6, 12 and 24 months after corneal transplantation. Sociodemographic and clinical characteristics, as well as coping styles as measured with the Utrecht Coping List, were considered as potential predictors for mental health outcomes (depression, anxiety, emotional health problems and fatigue). Linear mixed models were used to analyse and predict symptoms of depression, anxiety, emotional health problems and fatigue over time. Results: Scores on the CES-D and HADS-A improved significantly from baseline to 24-months (mean scores CES-D: 8.6 vs. 7.7, p = 0.03; mean scores HADS-A: 3.7 vs. 3.2, p = 0.002). Scores on the DAI-EH and DAI-F also improved significantly from baseline to 24-months (mean scores DAI-EH: 10.7 vs. 7.5, p < 0.001; mean scores DAI-F: 17.4 vs. 11.3, p < 0.001). Male sex and Fuchs' dystrophy were important predictors of better mental health outcomes, whereas comorbidity, (dry) eye complaints and a passive reacting coping style were important predictors of worse mental health outcomes. Conclusion: Corneal transplantation had a positive impact on mental health outcomes and important predictors were identified. This study may improve the understanding of patients and eyecare practitioners about the effects of corneal transplantation, leading to realistic communication about corneal transplantation expectations.

KW - anxiety

KW - corneal transplantation

KW - depression

KW - fatigue

KW - mental health

KW - patient-reported outcomes

U2 - 10.1111/opo.13432

DO - 10.1111/opo.13432

M3 - Article

SN - 0275-5408

VL - 45

SP - 340

EP - 351

JO - Ophthalmic and Physiological Optics

JF - Ophthalmic and Physiological Optics

IS - 2

ER -

Long-term mental health outcomes after corneal transplantation and potential predictors: A multicentre prospective cohort study

Abstract

Keywords

Access to Document

Fingerprint

Cite this