Keratoplasty for patients with severely impaired vision

It was estimated that in 1991 there were 51,000 severely visually handicapped individuals in Japan. These handicapped persons received a large amount of public support, including an allowance, a pension, exemption from income tax, and a number of other benefits such as discounts for public transportation and daily amenities. We report on how keratoplasty in 25 of these severely visually handicapped individuals affected their visual acuity and the amount of public support for which they qualified. Of the 25 individuals, 13 met criteria established by the Japanese Ministry of Health and Welfare for grade 1 physical disability and 12 met criteria for grade 2 disability. The patients' mean age was 68.1±13.8 years and they were followed for a mean of 605±346 days after surgery. After keratoplasty, the allograft remained clear in 22 cases (88%) and 22 (88% of those operated upon) achieved better than grade 3 status. Public support for these patients after surgery was estimated at 10 million yen each. Because public support could be discontinued for the 22 patients who achieved better than grade 3 status, keratoplasty in these severely visually handicapped patients proved to be very successful, not only from a medical point of view but also from a social welfare standpoint.