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Open AccessArticle

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

1
Institute of Medicine, Chung Shan Medical University, Taichung 402, Taiwan
2
Department of Ophthalmology, Show Chwan Memorial Hospital, Changhua 500, Taiwan
3
Department of Optometry, College of Medicine and Life Science, Chung Hwa University of Medical Technology, Tainan 717, Taiwan
4
Department of Otolaryngology–Head and Neck Surgery, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, Taiwan
5
Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou 333, Taiwan
6
Department of Medicine, Chang Gung University College of Medicine, Taoyuan 333, Taiwan
7
Center for Tissue Engineering, Chang Gung Memorial Hospital, Linkou 333, Taiwan
8
Department of Ophthalmology, Chang Gung Memorial Hospital, Keelung 204, Taiwan
9
Department of Chinese Medicine, Chang Gung University, Taoyuan 333, Taiwan
10
Department of Medical Research, Chung Shan Medical University Hospital, Taichung 402, Taiwan
11
Department of Optometry, Chung Shan Medical University, Taichung 402, Taiwan
12
Department of Exercise and Health Promotion, Chung Chou University of Science and Technology, Changhua 500, Taiwan
*
Author to whom correspondence should be addressed.
These authors contributed equally to the work.
Int. J. Environ. Res. Public Health 2019, 16(7), 1218; https://doi.org/10.3390/ijerph16071218
Received: 25 March 2019 / Revised: 3 April 2019 / Accepted: 3 April 2019 / Published: 5 April 2019
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. View Full-Text
Keywords: chronic rhinosinusitis; functional endoscopic sinus surgery; keratopathy; cornea; population-based chronic rhinosinusitis; functional endoscopic sinus surgery; keratopathy; cornea; population-based
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Hsu, H.-J.; Lee, C.-Y.; Yang, K.-L.; Chen, H.-C.; Sun, C.-C.; Huang, J.-Y.; Lin, H.-Y.; Yang, S.-F. The Development of Keratopathy after Surgery-Indicated Chronic Rhinosinusitis: A Population-Based Cohort Study. Int. J. Environ. Res. Public Health 2019, 16, 1218.

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