Abstract
The aim of the present study was to evaluate the risk of developing keratopathy in patients with surgery-indicated chronic rhinosinusitis (CRS) via the National Health Insurance Research Database in Taiwan. Patients with a diagnostic code of CRS and who received functional endoscopic sinus surgery (FESS) were considered to have surgery-indicated CRS. The exclusion criteria were legal blindness, an ocular tumor, eyeball removal or previous keratopathy, and each individual in the study group was matched to four non-CRS patients by age and sex. The outcome was set as the occurrence of keratopathy according to the diagnostic codes after the index date. Cox proportional hazard regression was used for statistical analysis. A total of 6053 patients with surgery-indicated CRS and another 24,212 non-CRS individuals were enrolled after exclusions. The age and sex distributions were identical between the two groups due to matching, while comorbidities, including hypertension, diabetes mellitus, and other cardiovascular disorders, were significantly higher in the study group. There were 231 episodes of keratopathy in the study group, and 695 episodes of keratopathy in the control group after the index date, for which study group showed a significantly higher rate of developing keratopathy with an adjusted hazard ratio of 1.208 and a higher cumulative probability. In subgroup analysis, female sex with surgery-indicated CRS showed a significantly greater risk of developing keratopathy. In conclusion, surgery-indicated CRS that needs FESS to relieve symptoms is a potential risk factor for keratopathy.
Highlights
Chronic rhinosinusitis (CRS) is an inflammatory disease in the paranasal sinuses that persists for at least 12 weeks [1] and is found in more than 10 percent of the population [2]
A total of 6053 patients with surgery-indicated chronic rhinosinusitis (CRS) were enrolled in the study group after exclusion, and other 24,212 individuals were enrolled in the control group
CRS that requires surgical management to relieve symptoms significantly increased the risk of developing in the current study after adjusting multiple potential risk factors
Summary
Chronic rhinosinusitis (CRS) is an inflammatory disease in the paranasal sinuses that persists for at least 12 weeks [1] and is found in more than 10 percent of the population [2]. The clinical presentation of CRS includes nasal discharge, pain in the facial region, reduction in the smell, headache, and shortness of breath [1,3]. Cranial nerve disorders, such as the alteration of trigeminal function, may occur in patients with CRS [4,5]. In its severe form, the infection and inflammation of the paranasal sinus in CRS may lead to a dreaded intracranial infection [6] Both medical and surgical management have been utilized to treat CRS [7]. Functional endoscopic sinus surgery (FESS) is a well-established intervention for CRS that is severe and refractory to medical management [8,9,10]
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