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Jacquelyn Jetton, Donald Stone, Yoonsang Kim; Effects of smoking on corneal healing time. Invest. Ophthalmol. Vis. Sci. 2013;54(15):2558.
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© ARVO (1962-2015); The Authors (2016-present)
To determine the effects of smoking on healing of corneal abrasions and keratitis.
A retrospective study of corneal abrasion and corneal ulcer. Primary outcome measured is time to epithelial closure compared between smokers and nonsmokers. Comorbidities studied were neurotrophic corneas, glaucoma, previous PK, atopy and sjogren’s/rheumatoid arthritis (RA). The data were analyzed using Kaplan Meier curves and Proportional Hazards models.
Eighty seven patients with corneal abrasions met inclusion criteria. Sixty six percent of the patients were nonsmokers and 33% were smokers. Mean healing time was 4.8 days in nonsmokers and 5.86 days in smokers (p-value 0.01). A Hazards Ratio (HR) <1 was seen for smokers despite all comorbidities. The comorbidities were studied after correcting for smoking. A statistically significant HR was seen in RA/Sjogrens, previous PK, and steroid treatment. Preliminary data show smoking delays healing in keratitis regardless of comorbidities. Average healing time in nonsmokers was 15 days versus 33 days in smokers (p = 0.02). We will present a larger sample evaluating comorbidities independent of smoking.
Epithelial healing is 22% delayed in smokers with corneal abrasions. Healing at follow up is 73% more likely in nonsmokers despite any comorbidity. Patients with RA/Sjogrens and a previous PK had delayed healing regardless of smoking. Preliminary data of keratitis patients suggest smokers required twice the time for epithelial closure. Final data for keratitis patients will be presented. In summary, smoking status appears to have a significant effect on corneal epithelial healing time both in patients with simple corneal abrasions and those with corneal ulcers, which is consistent with our clinical observations. This is potentially important in the clinical setting in regards to appropriate follow up and patient counseling. Lifestyle counseling (such as diet and exercise) has become a prominent part of the doctor-patient relationship and patients must be aware of and counseled on the potential effects of smoking on the health of their eyes.
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