本研究目的在透過臺灣國家健康保險研究資料庫，評估需手術的慢性鼻竇炎(Chronic Rhinosinusitis; CRS)患者罹患角膜病變的風險。需要手術的CRS是取具有CRS診斷代碼且接受過功能性內視鏡鼻竇手術(functional endoscopic sinus surgery; FESS)的患者。排除標準是失明，眼部腫瘤，眼球移除或曾經有過任何角膜病變的患者，實驗組每個人的年齡和性別都與4名非CRS患者相匹配。利用索引日期後所產生的角膜病變診斷代碼當作收案的依據。統計分析使用Cox proportional hazard regression。共有6,053名需要手術的CRS的患者和另外24,212名非CRS患者在排除條件不符後納入統計。兩組之間的年齡和性別的分佈在互相比對後是相同的，而實驗組的高血壓，糖尿病和其他心血管疾病較對照組有較高的發生率。索引日期之後實驗組有231次角膜病變，對照組則有695次角膜病變，實驗組比對照組的adjusted hazard ratio 高出1.208倍並有著較高的cumulative probability。在次組群分析中，在需要手術的CRS女性病患顯示有更高的角膜病變風險。因此，我們的結論發現，需要功能性內視鏡鼻竇手術的慢性鼻竇炎是角膜病變的潛在危險因子。
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 signi?cantly 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 signi?cantly 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 signi?cantly greater risk of developing keratopathy. In conclusion, surgery-indicated CRS that needs FESS to relieve symptoms is a potential risk factor for keratopathy.
