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HSIEN-CHANG Lin, Roni Shtein, Bin Nan, Joshua D. Stein; Changes in Rates of Keratoplasty for Corneal Endothelial Disease and Outcomes from 2001-2009. Invest. Ophthalmol. Vis. Sci. 2011;52(14):5534.
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To determine impact of the transition from penetrating to endothelial keratoplasty for treatment of corneal endothelial disease (CED) we evaluated rates of procedures performed for a cohort of individuals with CED who were enrolled in a large national US managed care network between 2001-2009.
All individuals age>=50 enrolled in a managed care network with diagnosed CED were identified. Rates of keratoplasty for CED were determined at 6 month intervals from January 2001 through December 2009. Logistic regression was performed to identify sociodemographic and other factors associated with undergoing keratoplasty for CED.
A total of 2,328 keratoplasty procedures were performed for CED during the decade (range: 82-171 each 6 month interval). Rates of keratoplasty for CED were relatively stable from 2001 through mid 2007 (4-6/1000 person-half years) increasing up to 7-8/1000 person-half years in 2009. Factors associated with an increased odds of undergoing keratoplasty for CED included female sex, Latino or Asian American race (relative to whites), and lower income. Persons residing in Midwestern and Western US states had a 14% and 16% decreased odds, respectively, of undergoing keratoplasty for CED relative to individuals residing in Northeastern states. (p<0.0001). Comorbid pseudophakia/aphakia (OR=1.28: CI,1.24-1.33) , non-proliferative diabetic retinopathy (OR=1.25, CI 1.18-1.32), and neovascular macular degeneration (OR=1.34, CI: 1.24-1.45) were associated with increased odds of keratoplasty for CED. Persons residing in states with higher density of ophthalmologists had a higher odds of undergoing keratoplasty for CED (p=0.001). Odds of keratoplasty for CED were 6-27% lower each year from 2001-2008 relative to 2009.
The transition from penetrating to endothelial keratoplasty has resulted in higher rates of these procedures performed for patients with CED. Factors associated with an increased odds of keratoplasty for CED included sociodemographic factors, comorbid ocular conditions, and location of residence in the US.
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