Abstract
Purpose :
To assess the long-term risk of developing a new diagnosis of depressive episodes, antidepressant use, dry eye syndrome (DES), chronic pain syndrome, trigeminal neuralgia, and neurotrophic keratopathy following corneal refractive surgery.
Methods :
A retrospective cohort study was performed using TriNetX (Cambridge, MA, USA), an electronic database containing millions of patients from more than 70 health organizations. Patients with refractive error were identified using relevant ICD-10 codes and were divided into two cohorts: those with and without a history of corneal refractive surgery (Z98.890). Using 1:1 propensity score matching, cohorts were matched for demographics, mental health, and dry eye related comorbidities identified using the relevant ICD-10 codes. Primary outcome measures were lifetime diagnosis rates of depressive episodes (F32), antidepressant use (CN600), DES (H04.12), chronic pain syndrome (G89.4), trigeminal neuralgia (G50.0), and neurotrophic keratopathy (H16.231, H16.232, H16.233, H16.239, H16.8). Patients with prior diagnosis of the studied outcomes were excluded. Relative risk (RR) with 95% confidence intervals was used to compare the outcomes between the two cohorts.
Results :
This study included a total of 488,786 patients with 244,393 patients in each cohort. The post-refractive surgery group had statistically significant lower rates of new diagnosis of depressive episodes (RR 0.80; 0.79-0.82), antidepressant use (RR 0.78; 0.77-0.79), DES (RR 0.96; 0.94-0.98), chronic pain syndrome (RR 0.89; 0.85-0.92) and trigeminal neuralgia (RR 0.84; 0.76-0.93). There was no significant difference in the rate of neurotrophic keratopathy between the two groups (p = 0.21).
Conclusions :
Corneal refractive surgery was not associated with an increased lifetime risk of new diagnosis of depressive episodes, DES, chronic pain syndrome, trigeminal neuralgia, and neurotrophic keratopathy.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.