Risk of corneal transplantation after phacoemulsification in patients with cornea guttata

Abstract

AbstractPurposeTo investigate the risk of corneal transplantation after phacoemulsification related to cornea guttata.MethodsIn this retrospective registry‐based cohort study, patient data from the Swedish National Cataract Register for years 2010‐2012 were linked with data from the Swedish Cornea Transplant Register for years 2010‐2017. Altogether, data from 276,354 cataract patients was linked with data from 2,091 patients with primary and secondary endothelial failure as indication for corneal transplantation. Other surgical methods for cataract extraction than phacoemulsification were excluded. If both eyes had surgery, one eye was randomly selected to obtain unrelated samples. A Kaplan‐Meier curve and Cox regression analysis were used to investigate the risk for corneal transplantation due to endothelial failure after phacoemulsification.ResultsOut of the 3,346 phacoemulsification patients with cornea guttata, 153 underwent corneal transplantation within 6.2 years in median. The cumulative transplantation rate, 6 years after the phacoemulsification was 4.8% in the group with cornea guttata and 0.08% in the group without. The annual transplantation rate among the cornea guttata patients during the first year was 1.64% and diminished the following 5 years to 0.55% in average. The annual transplantation rate among the patients without cornea guttata was 0.01% in average after phacoemulsification during the same period of time. The transplantation hazard ratio for cornea guttata present at the phacoemulsification was 67.6 (95% CI: 53.6.0‐85.3, p < 0.001), when adjusting for potential confounders.ConclusionsThe hazard of corneal transplantation after phacoemulsification was 67.6 times higher with cornea guttata than without. Still, the great majority of the patients with cornea guttata did not undergo corneal transplantation during the study period.