Hsu Yung-Nan, Chiang Whei-Ling, Huang Jing-Yang, Lee Chia-Yi, Su Shih-Chi, Yang Shun-Fa
Institute of Medicine, Chung Shan Medical University, Taichung 402, Taiwan.
Department of Physical Therapy and Rehabilitation, Chang Bing Show Chwan Memorial Hospital, Changhua 505, Taiwan.
Diagnostics (Basel). 2024 Sep 11;14(18):2013. doi: 10.3390/diagnostics14182013.
Penetrating keratoplasty (PK) is a corneal surgery that is employed to repair the full-thickness corneal lesion. This study aimed to survey the possible systemic risk factors of infectious keratitis after penetrating keratoplasty (PK) via the Taiwan National Health Insurance Research Database (NHIRD). A retrospective case-control study was conducted, and 327 patients who received the PK were enrolled after exclusion. The main outcome was the development of infectious keratitis, and people were divided into those with infectious keratitis and those without the outcome. Cox proportional hazard regression was conducted to produce adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) of specific demographic indexes and systemic diseases on infectious keratitis. There were 68 patients who developed infectious keratitis after the whole follow-up period. The diabetes mellitus (DM) (aHR: 1.440, 95% CI: 1.122-2.874, = 0.0310) and chronic ischemic heart disease (aHR: 1.534, 95% CI: 1.259-3.464, = 0.0273) groups demonstrated a significant association with infectious keratitis. The DM group also revealed significant influence on infectious keratitis development in all the subgroups (all < 0.05). Nevertheless, the effect of chronic ischemic heart disease on infectious keratitis was only significant on those aged older than 60 years ( = 0.0094) and both sexes (both < 0.05). In conclusion, the presence of DM and chronic ischemic heart disease are associated with infectious keratitis after PK. However, local risk factors for infectious keratitis developed in those receiving PK had not been evaluated.
穿透性角膜移植术（PK）是一种用于修复全层角膜病变的角膜手术。本研究旨在通过台湾国民健康保险研究数据库（NHIRD）调查穿透性角膜移植术（PK）后感染性角膜炎可能的全身危险因素。进行了一项回顾性病例对照研究，排除后纳入327例接受PK的患者。主要结局是感染性角膜炎的发生，患者被分为发生感染性角膜炎组和未发生该结局组。进行Cox比例风险回归分析以得出特定人口统计学指标和全身性疾病对感染性角膜炎的调整风险比（aHRs）及95%置信区间（CIs）。在整个随访期后，有68例患者发生了感染性角膜炎。糖尿病（DM）组（aHR：1.440，95%CI：1.122 - 2.874，P = 0.0310）和慢性缺血性心脏病组（aHR：1.534，95%CI：1.259 - 3.464，P = 0.0273）与感染性角膜炎有显著关联。DM组在所有亚组中对感染性角膜炎的发生也显示出显著影响（均P < 0.05）。然而，慢性缺血性心脏病对感染性角膜炎的影响仅在60岁以上人群中显著（P = 0.0094），且在两性中均显著（均P < 0.05）。总之，DM和慢性缺血性心脏病的存在与PK后感染性角膜炎相关。然而，接受PK患者发生感染性角膜炎的局部危险因素尚未评估。
