Abstract
Purpose :
To test the hypothesis that there are regional differences in the annual rate of Fuchs Endothelial Keratoplasty (EK) and to study these differences based on regional differences in smoking.
Methods :
The Eye Bank Association of America (EBAA) provided data concerning EK tissue utilized for Fuchs Dystrophy in 2016. In order to preserve confidentiality, EBAA provided aggregate data from 6 US regions: Northeast, Atlantic, Midwest, South, Heartland, and West. A total of 15,653 EKs were reported, 3802 in the West, 1325 in the Heartland, 991 in the Northeast, 2126 in the Atlantic, 2319 in the South, and 5072 in the Midwest. The most recent US census data was used to calculate regional rates of Fuchs EK per 100,000 people. NIH estimates of smoking were used with census data to calculate the “% Ever Smoked 100 Cigarettes” for each region. The regions were then split into two groups: “higher regional smoke exposure” (Three regions with highest exposure) and “lower regional smoke exposure” (Three regions with lowest exposure). Incidences were compared by Pearson’s Χ2 test.
Results :
The annual rate of Fuchs EK varied widely, ranging from 7.77/100,000 people in the Atlantic to 1.76/100,000 in the Northeast. When regions were grouped according to smoke exposure, the “higher smoke exposure”(Atlantic, South, Midwest) group had a higher combined incidence of Fuchs EK than the “lower smoke exposure” (Northeast, West, Heartland) group (6.3 vs. 3.6/100,000 people, respectively; p < 0.001).
Conclusions :
Regional rates of EK for Fuchs Dystrophy may be associated with environmental factors such as smoking. Further exploration of environmental factors impacting the incidence or progression of Fuchs is important because their management would have a significant impact on public health by possibly decreasing the future need for corneal transplants.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.