Purpose

To estimate the incidence of corneal endothelial transplantation and identify risk factors among patients with non-infectious ocular inflammation.

Design

Retrospective cohort study.

Methods

Adult patients attending United States tertiary uveitis care facilities diagnosed with non-infectious ocular inflammation were identified from the Systemic Immunosuppressive Therapy for Eye Diseases Cohort Study. Time-to-event analysis was used to estimate the incidence of corneal endothelial transplantation (CET), including penetrating keratoplasty, Descemet stripping endothelial keratoplasty, or Descemet Membrane Endothelial Keratoplasty procedures. The incidence of CET was calculated; potential risk factors for CET were also evaluated using Cox regression, accounting for correlation between eyes of the same patient.

Results

Overall, 14,264 eyes met eligibility criteria for this analysis with a median follow-up 1.8 eye-years. The Kaplan-Meier estimated incidence of CET within 10 years was 1.10% (95% CI, 0.68%-1.53%). Risk factors for CET included age >60 years vs. <40 years (aHR 16.5; 95% CI,4.70-57.9), anterior uveitis and scleritis vs. other types (aHR 2.97; 95% CI, 1.46-6.05 and aHR 4.14; 95% CI,1.28-13.4, respectively), topical corticosteroid treatment (aHR 2.84; 95% CI, 1.32-6.13), cataract surgery (aHR 4.44; 95% CI, 1.73-11.4), tube shunt surgery (aHR 11.9; 95% CI, 5.30-26.8), band keratopathy (aHR 5.12; 95% CI, 2.34-11.2), and hypotony (aHR 7.38; 95% CI, 3.14-17.4). Duration of uveitis, trabeculectomy, PAS, and ocular hypertension had no significant association after multivariate adjustment.

Conclusions: In patients with ocular inflammation, CET occurred infrequently. Tube shunt surgery, hypotony, band keratopathy, cataract surgery, and anterior segment inflammation were associated with increased risk of undergoing corneal endothelial transplantation; these factors likely are associated with endothelial cell damage.

中文翻译：

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葡萄膜炎的角膜内皮移植：发病率和危险因素

目的

估计角膜内皮移植的发生率并确定非感染性眼部炎症患者的危险因素。

设计

回顾性队列研究。

方法

就诊于美国三级葡萄膜炎护理机构并被诊断患有非感染性眼部炎症的成年患者是从眼病的全身免疫抑制治疗队列研究中鉴定出来的。事件发生时间分析用于估计角膜内皮移植 (CET) 的发生率，包括穿透性角膜移植术、后弹力剥离内皮角膜移植术或后弹力膜内皮角膜移植术。计算CET的发生率；还使用 Cox 回归评估了 CET 的潜在危险因素，考虑了同一患者眼睛之间的相关性。

结果

总体而言，有 14,264 只眼睛符合该分析的资格标准，中位随访时间为 1.8 眼年。Kaplan-Meier 估计 10 年内 CET 的发生率为 1.10%（95% CI，0.68%-1.53​​%）。CET 的危险因素包括年龄 >60 岁与 <40 岁（aHR 16.5；95% CI，4.70-57.9）、前葡萄膜炎和巩膜炎与其他类型（aHR 2.97；95% CI，1.46-6.05 和 aHR 4.14； 95% CI，分别为 1.28-13.4）、局部皮质类固醇治疗（aHR 2.84；95% CI，1.32-6.13）、白内障手术（aHR 4.44；95% CI，1.73-11.4）、管分流手术（aHR 11.9；95 % CI，5.30-26.8）、带状角膜病（aHR 5.12；95% CI，2.34-11.2）和低眼压（aHR 7.38；95% CI，3.14-17.4）。多变量调整后，葡萄膜炎持续时间、小梁切除术、PAS 和高眼压症没有显着关联。

结论：在眼部炎症患者中，CET很少发生。管分流手术、低眼压、带状角膜病变、白内障手术和眼前节炎症与接受角膜内皮移植的风险增加有关；这些因素可能与内皮细胞损伤有关。