Impact of Scleral Contact Lens Use on the Rate of Corneal Transplantation for Keratoconus.
Journal
Cornea
ISSN: 1536-4798
Titre abrégé: Cornea
Pays: United States
ID NLM: 8216186
Informations de publication
Date de publication:
Jan 2021
Jan 2021
Historique:
pubmed:
27
5
2020
medline:
13
8
2021
entrez:
27
5
2020
Statut:
ppublish
Résumé
To evaluate the association of scleral contact lens (SCL) use on the risk for keratoplasty for people with keratoconus. The electronic health records of patients receiving eye care at the University of Michigan Kellogg Eye Center between August 1, 2012, and December 31, 2018, were reviewed. Patients with a diagnostic code of keratoconus or corneal ectasia, no previous history of keratoplasty, and for whom data were available for both eyes were included. Using a multivariable Cox regression model, associations between SCL use and keratoplasty were tested and adjusted for sociodemographic factors, maximum keratometry, and current contact lens (CL) use. Two thousand eight hundred six eyes met the inclusion criteria. CL use in each eye was 36.2% with no CL, 7.2% soft, 33.9% rigid gas permeable (RGP), and 22.7% scleral. A total of 3.2% of eyes underwent keratoplasty. In the adjusted model, SCL or RGP CL use significantly lowered the hazard of undergoing keratoplasty (HR = 0.19, 95% confidence interval [CI] 0.09-0.39, P < 0.0001 and HR = 0.30, 95% CI 0.17-0.52, P < 0.0001, respectively) when compared with no CL use. Factors associated with increased risk of keratoplasty were black race as compared to white (HR = 1.87, 95% CI 1.10-3.16, P = 0.02), younger age (HR = 0.92 per 5-year increment, 95% CI 0.86-0.99, P = 0.032), and lower socioeconomic status (HR = 1.08 per 5-point increase in the Area Deprivation Index, 95% CI 1.03-1.13, P = 0.0008). Keratoplasty was not associated with sex, insurance, or maximum keratometry. Physicians should maximize the use of scleral or RGP CL because patients who successfully use CL have almost one-fifth the risk of undergoing keratoplasty.
Identifiants
pubmed: 32452985
doi: 10.1097/ICO.0000000000002388
pmc: PMC7686092
mid: NIHMS1583681
pii: 00003226-202101000-00007
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
39-42Subventions
Organisme : NEI NIH HHS
ID : R01 EY031033
Pays : United States
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