Purpose: this study aimed to assess the frequency of complications related to corneal grafts, including epithelialization disorders, wound dehiscence, infectious keratitis, recurrence of herpetic keratitis, graft rejection, late graft failure, and infectious and noninfectious corneal melting, while also considering risk factors, particularly indications. Methods: this retrospective analysis of corneal graft failure included a chart review of the hospital records of patients who underwent penetrating keratoplasty (PK) between January 2016 and December 2020 at the Department of Ophthalmology of the District Railway Hospital, Katowice, Poland. Results: Between 2016 and 2020, a total of 758 PK procedures were carried out at the ophthalmology department. Bullous keratopathy (20.58%), keratoconus (18.07%), and corneal perforation (13.32%) were the primary indications for keratoplasty. Secondary glaucoma was diagnosed in 99 patients (13.06%). The success rate of PK was 72.43% (494). The most frequent treatment complication was secondary glaucoma (13.06%), followed by late endothelial failure, perforation (4.1%), and bacterial keratitis (3.23%). Patients in the high-risk group were 4.65 times more likely to develop complications than those in the low-risk group. Multivariate regression analysis showed that concomitant ophthalmic diseases (odds ratio (OR): 3.12, confidence interval (CI): 1.60–6.08, p = 0.00) and connective tissue diseases (OR: 7.76, CI: 2.40–25.05, p = 0.00) were significant factors associated with the occurrence of complications. Diabetes, dermatological diseases, primary glaucoma, and sex were not associated with corneal graft failure (p > 0.05). Conclusion: Chronic loss of the endothelium was the primary cause of graft failure in individuals who underwent PK. The high-risk transplant has up to 4.65 times higher risk of complications compared to the indications with a good prognosis.

Visual acuity is one of the most important parameters for evaluating the vision of patients with keratoconus. This study reviewed 295 articles related to keratoconus published between 2017 and 2022 in which visual acuity was one of the parameters measured. The methodology of visual acuity testing in studies on keratoconus was thoroughly analyzed. The analysis showed that the most commonly indicated chart for testing visual acuity papers on keratoconus is the Snellen chart. It was shown that in 150 out of 295 articles, the authors do not describe the methodology for testing visual acuity. What is more, it was also shown that in 68 of the 295 articles which were analyzed, a procedure for converting visual acuity tested with a Snellen chart into a logMAR scale was used. In this review, we discuss the validity and reliability of such conversions. In particular, we show that insufficient description of visual acuity testing methodology and lack of information on the conversion of visual acuity results into the logMAR scale may contribute to the misinterpretation of visual acuity test results.

Background/Objectives: Keratoconus is a progressive corneal disorder that significantly impairs visual quality and daily functioning. This study aimed to translate, culturally adapt, and validate the Polish version of the Keratoconus Outcomes Research Questionnaire (KORQ), a tool designed to assess keratoconus-related vision problems and their impact on quality of life. Methods: This study involved three phases: translation, validation, and optimization. The translation followed cross-cultural adaptation guidelines, including forward translation, back translation, and pretesting. In the validation phase, 100 patients with keratoconus completed the Polish KORQ. Psychometric properties were assessed using Rasch analysis to evaluate item fit, reliability, unidimensionality, and targeting. Exploratory and confirmatory factor analyses (EFA and CFA) were conducted to examine the latent structure of the questionnaire. Regression analysis examined the demographic and clinical factors influencing keratoconus severity and vision-related quality of life, with the total KORQ score as the dependent variable. Results: The Polish KORQ demonstrated excellent psychometric properties. Internal consistency was high (α = 0.95 for activity limitation, α = 0.87 for symptoms). Rasch analysis confirmed good item fit and measurement reliability. EFA identified a two-factor structure consistent with the original questionnaire, explaining 53% of the total variance. CFA supported this model, with good fit indices (CFI = 0.981, TLI = 0.980), despite slightly elevated RMSEA (0.104) and SRMR (0.109). The two latent factors were moderately correlated (r = 0.729). Regression analysis showed that uncorrected visual acuity and disease severity significantly predicted lower quality of life. Conclusions: The Polish KORQ is a reliable and valid tool for assessing the impact of keratoconus in clinical and research settings.

Background/Objectives: This study assessed outcomes between penetrating keratoplasty (PK) and Descemet’s stripping automated endothelial keratoplasty (DSAEK) when combined with cataract surgery as part of the triple procedure. Methods: Retrospective analysis of 727 triple procedures (525 PK and 202 DSAEK) from 2007–2023. Graft survival, visual acuity, and refractive outcomes were analyzed. Kaplan–Meier and Cox regression were used for survival and prognostic analysis. Results: No statistically significant difference in survival was found (PK—42 months; DSAEK—47 months). DSAEK had better visual acuity improvement and refractive stability. PK had higher astigmatism and variability in refractive error. Conclusions: While graft survival was comparable, DSAEK offers superior visual rehabilitation, supporting its use when refractive predictability is important.

The present review aimed to investigate the impact of keratoconus on patient well-being. Improving the quality of life of patients remains a key focus in modern medicine. The advent of advanced therapeutic methods has significantly slowed the progression of numerous diseases. Among the various causes of visual impairment, corneal diseases play a major role. Statistically, one in four people with vision problems suffers from a corneal condition. In particular, keratoconus is a pressing concern globally, affecting a significant portion of the young and working-age population. Researchers have investigated various factors that contribute to the development of keratoconus, including genetic, environmental, mechanical, allergic, and other causes. As the disease progresses, it can severely affect the quality of life of patients. However, surgical treatments such as cross-linking have shown significant improvements, leading to reduced anxiety and better overall outcomes. With the advancements in diagnostic technology, healthcare providers can now assess and enhance the quality of life for keratoconus patients during treatment.

To evaluate the impact of keratoconus on visual quality and quality of life among Polish patients by integrating subjective assessments using the Keratoconus Outcomes Research Questionnaire (KORQ) with objective clinical measurements. A total of 100 patients (80% men, 20% women; median age: 39 years) with clinically diagnosed keratoconus completed the locally validated Polish version of the KORQ, including two subscales: Activity Limitation (18 items) and Symptoms (9 items). Objective data collected included best-corrected visual acuity (BCVA), corneal topography, pachymetry, and higher-order aberrations (HOA). Statistical analyses included biweight midcorrelations and robust linear regression models adjusted for age and gender. The mean Activity Limitation score was 51.53 (SD = 17.19) and the Symptoms score was 55.60 (SD = 16.14), indicating moderate functional impairment and symptom burden. The most challenging activities were night driving (mean = 2.06), seeing small distant objects (mean = 2.09), and coping with poor lighting (mean = 2.05). The most bothersome symptoms were distorted vision (mean = 1.84), sensitivity to smoke (mean = 2.05), and dusty environments (mean = 2.01). Higher-order aberrations, especially in the worse-seeing eye, showed the strongest associations with KORQ scores across both subscales (e.g., for Symptom subscale: HOA: β = 2.84; p = 0.004; vertical coma: β = 5.83; p = 0.019), while BCVA in the better-seeing eye was significantly associated with both lower symptom burden (β = -9.83; p = 0.047) and functional limitation (β = -12.13; p = 0.042). Traditional structural parameters, such as Kmax and corneal thickness, showed no significant predictive value. Keratoconus significantly impairs visual functioning and causes a high symptom burden among Polish patients. Best-corrected visual acuity and higher-order aberrations, especially in the worse-seeing eye, are the strongest predictors of reduced vision-related quality of life. These findings emphasize the need to focus clinical management on improving optical quality, rather than solely correcting structural corneal features.