The Development of Keratopathy after Surgery-Indicated Chronic Rhinosinusitis: A Population-Based Cohort Study

Hung-Jui Hsu, Chia-Yi Lee, Kun-Lin Yang, Hung-Chi Chen, Chi-Chin Sun, Jing-Yang Huang, Hung-Yu Lin and Shun-Fa Yang
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Hung-Jui Hsu: Institute of Medicine, Chung Shan Medical University, Taichung 402, Taiwan
Chia-Yi Lee: Department of Ophthalmology, Show Chwan Memorial Hospital, Changhua 500, Taiwan
Kun-Lin Yang: Department of Otolaryngology–Head and Neck Surgery, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, Taiwan
Hung-Chi Chen: Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou 333, Taiwan
Chi-Chin Sun: Department of Ophthalmology, Chang Gung Memorial Hospital, Keelung 204, Taiwan
Jing-Yang Huang: Department of Medical Research, Chung Shan Medical University Hospital, Taichung 402, Taiwan
Hung-Yu Lin: Institute of Medicine, Chung Shan Medical University, Taichung 402, Taiwan
Shun-Fa Yang: Institute of Medicine, Chung Shan Medical University, Taichung 402, Taiwan

IJERPH, 2019, vol. 16, issue 7, 1-9

Abstract: The aim of the present study was to evaluate the risk of developing keratopathy in patients with surgery-indicated chronic rhinosinusitis (CRS) via the National Health Insurance Research Database in Taiwan. Patients with a diagnostic code of CRS and who received functional endoscopic sinus surgery (FESS) were considered to have surgery-indicated CRS. The exclusion criteria were legal blindness, an ocular tumor, eyeball removal or previous keratopathy, and each individual in the study group was matched to four non-CRS patients by age and sex. The outcome was set as the occurrence of keratopathy according to the diagnostic codes after the index date. Cox proportional hazard regression was used for statistical analysis. A total of 6053 patients with surgery-indicated CRS and another 24,212 non-CRS individuals were enrolled after exclusions. The age and sex distributions were identical between the two groups due to matching, while comorbidities, including hypertension, diabetes mellitus, and other cardiovascular disorders, were significantly higher in the study group. There were 231 episodes of keratopathy in the study group, and 695 episodes of keratopathy in the control group after the index date, for which study group showed a significantly higher rate of developing keratopathy with an adjusted hazard ratio of 1.208 and a higher cumulative probability. In subgroup analysis, female sex with surgery-indicated CRS showed a significantly greater risk of developing keratopathy. In conclusion, surgery-indicated CRS that needs FESS to relieve symptoms is a potential risk factor for keratopathy.

Keywords: chronic rhinosinusitis; functional endoscopic sinus surgery; keratopathy; cornea; population-based (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2019
References: View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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