Corneal transplant failure associated with smoking

Abstract

This retrospective study was conducted in the University of Missouri's cornea transplant service from January 1, 2010 to September 30, 2015 to determine whether smoking increases the risk of corneal transplant failure. Cornea transplant patient's records were identified via the Informatics for Integrity Biology and the Bedside data query portal using the ICD-9 codes for penetrating keratoplasty (11.64), endothelial keratoplasty (11.62, 11.63 and 11.69) and 996.51 for corneal transplant failures. A total of 257 patients were identified. The study sample was 52% female and 48% male. A total of 151 patients had penetrating keratoplasty, while 106 had endothelial keratoplasty. Penetrating keratoplasty patients with a history of smoking had a significantly higher rate of transplant failure (73%) versus those with no history of smoking (53%). Endothelial keratoplasty patients with a smoking history had a slightly higher rate of transplant failure (33.3%) versus those with no history of smoking (30%). Glaucoma patients with smoking habits also had a higher transplant failure rate (70%) compared to glaucoma patients without a smoking history (52%). Further, the study showed that female smokers and younger smokers (<54) have higher transplant failure rates. Overall the study found that patients with a history of smoking have higher rates of corneal transplant failure than non-smokers.

Impact of tobacco use on corneal thickness and endothelial health: a systematic review with meta‐analyses

“…Here, smoking lead to a significantly higher risk of developing Fuchs' endothelium corneal dystrophy with OR = 1.36 (p = 0.02) in the univariate analysis and OR = 1.30 (p = 0.047) in the multivariate analysis (Zhang et al 2013). Fraunfelder et al (2017) reported higher transplant failure rates in smokers compared to non-smokers after endothelial transplantation (Fraunfelder et al 2017). These findings provide further strength to the hypothesis that a clinically significant impact of smoking on corneal health should be expected in those with a priori poor corneal prognosis.…”