ABSTRACT
PURPOSE: The association between autoimmune diseases and keratoconus (KC) has been proposed based on previous retrospective studies and case reports. The aim of our study is to investigate whether KC is associated with autoimmune thyroid disease. Methods. A comparative study was conducted on 131 adult subjects from September 2015 to May 2017 at Jordan University Hospital, Amman, Jordan. Subjects were classified into 2 groups: subjects with autoimmune thyroid disease, including Graves' disease and Hashimoto's thyroiditis (n = 68), and a healthy group for comparison (n = 63). Subjects with any other conditions known to be associated with KC were excluded. The diagnosis of KC was based on clinical and corneal topographic findings utilizing the Oculus-Pentacam machine. In addition, TSH and total T4 levels as well as thyroid peroxidase antibodies were measured in all study participants. Antithyroglobulin antibodies, thyroid stimulating immunoglobulin, thyroid ultrasound, and thyroid uptake and scan were also selectively performed in some participants. RESULTS: This study included a total of 131 participants (101 females and 30 males), including patients and controls. In the multivariate analysis, autoimmune disease was not significantly associated with keratoconus (OR = 1.1; 95% confidence interval: 0.3, 3.8; p value = 0.353) after adjusting for age and gender. CONCLUSION: This study did not show a statistically significant association between autoimmune thyroid disease and KC.
ABSTRACT
PURPOSE: The outcomes of penetrating keratoplasty (PK) were compared using local corneas obtained at the same hospital in which they were transplanted with corneas obtained from the United States and grafted at the Jordan University Hospital. METHODS: A retrospective, nonrandomized review included the medical records of 484 patients who underwent PK at the Jordan University Hospital from 2007 to 2009. Patients with at least 18 months of follow-up included 71 patients in the local group and 75 patients who received imported corneas. Data regarding the preoperative vision and diagnosis, tissue characteristics, preservation-to-surgery time of donor tissue on graft survival, and postoperative outcomes were collected. RESULTS: One hundred forty-six patients (mean age, 31.8 yrs ± 18.3 SD; range, 13-80 yrs) were included. Ninety-three (63.7%) patients were men. The most common indications for PK were keratoconus (67.8%) and corneal opacity (11%). Both groups were similar in age, indications, and outcomes. The success rates for PK after 18 months were 86% and 88% in the local and imported cornea groups, respectively; the difference between them did not reach significance (P = 0.196). The only significant (P < 0.001) factor was a longer preservation-to-surgery time in the imported group (8.6 ± 2.9 d) compared with the local group (4.5 ± 2.2 d). CONCLUSIONS: The success rate for PK remains relatively high (average, 87%) with both local and imported corneas. Despite the longer preservation-to-surgery time and older donor age for the imported corneas, no significant difference in graft outcomes was seen between the 2 groups.
