Orbital Unit, Moorfields Eye Hospital, London, United Kingdom.
Ophthalmology. 2011 Dec;118(12):2493-7. doi: 10.1016/j.ophtha.2011.06.003. Epub 2011 Aug 27.
To investigate the relationship between smoking status at presentation and the use of strabismus surgery in the management of patients with thyroid eye disease.
Retrospective review of a noncomparative series of patients with thyroid eye disease.
All patients with thyroid eye disease under the care of a single consultant at Moorfields Eye Hospital between 1997 and 2002 (inclusive).
Retrospective review of clinical case notes.
Survival analysis of patients in cohort and the frequency of strabismus surgery in relation to smoking status at ophthalmic presentation. A subanalysis of patients who underwent orbital decompression and those that did not was undertaken.
Of 501 patients seen during the study period, 425 (85%) of 501 sets of notes were available for review, and initial smoking status was recorded for 89% (378/425) of patients, of whom approximately one half (196/378; 52%) were active smokers. Of the smokers, 51 (26%) of 196 underwent strabismus surgery, compared with only 19 (14%) of 138 nonsmokers at presentation. When adjusted for age, the hazards ratio of having strabismus surgery during management for smokers at presentation versus nonactive smokers was 2.19. In the group who did not undergo orbital decompression, this hazard ratio increased to 4.86.
Within this thyroid eye disease cohort, the proportion of smokers at presentation was much larger than that of the general population. There was an increased use of strabismus surgery in active smokers at presentation than in nonactive smokers. This finding was independent of the orbital decompression surgery. The results are consistent with those of previous reports of more severe thyroid eye disease in smokers and raise the possibility that smoking cessation early in the disease may reduce the severity of the changes and the number of rehabilitative strabismus operations needed.
FINANCIAL DISCLOSURE(S): The author(s) have no proprietary or commercial interest in any materials discussed in this article.
研究就诊时的吸烟状况与甲状腺眼病患者斜视手术治疗的关系。
回顾性分析甲状腺眼病患者的非对照系列。
1997 年至 2002 年（含）期间在 Moorfields 眼科医院接受单一顾问治疗的所有甲状腺眼病患者。
回顾性分析临床病历。
队列患者的生存分析以及与眼科就诊时吸烟状况相关的斜视手术频率。对接受眼眶减压术和未接受眼眶减压术的患者进行了亚分析。
在研究期间，共观察了 501 例患者，其中 425 例（85%）的病历可用于回顾性分析，89%（378/425）的患者记录了最初的吸烟状况，其中约一半（196/378；52%）为吸烟者。在吸烟者中，196 例（26%）接受了斜视手术，而在初诊时的 138 例非吸烟者中，只有 19 例（14%）接受了斜视手术。调整年龄后，就诊时吸烟者与非活跃吸烟者在管理期间接受斜视手术的风险比为 2.19。在未行眼眶减压术的患者中，这一风险比增加到 4.86。
在本甲状腺眼病队列中，就诊时吸烟者的比例远高于普通人群。活跃吸烟者在就诊时比非活跃吸烟者更倾向于接受斜视手术。这一发现与之前的报告一致，即吸烟者的甲状腺眼病更为严重，并提出了这样一种可能性，即疾病早期戒烟可能会减轻变化的严重程度和需要进行的斜视手术的数量。
作者在本文讨论的任何材料中均没有所有权或商业利益。
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