Aim To determine the relationship between corneal refractive surgery and the prevalence of glaucoma in the Korean population.
Methods Data were obtained from the Korea National Health and Nutrition Examination Survey (KNHANES), a population-based cross-sectional study using a complex, stratified, multistage, probability-cluster survey. This study included 604 eyes that had undergone myopic corneal refractive surgery, and 3389 control eyes without a history of any ocular surgery and having a spherical equivalent (SE) <−3.00 D, obtained from the KNHANES database for the years 2010–2012. Glaucoma diagnosis was based on the International Society of Geographical and Epidemiological Ophthalmology criteria. The association between a history of corneal refractive surgery and the prevalence of glaucoma was analysed using logistic regression analysis, after adjusting for potential confounding factors.
Results Glaucoma prevalence did not differ between eyes that had and had not undergone corneal refractive surgery (p=0.675). After adjusting for age, sex, SE, and intraocular pressure, multivariate logistic regression analysis found that corneal refractive surgery was significantly associated with an increased risk of glaucoma (OR 9.14, p=0.002; 95% CI 2.22 to 37.69). Subgroup analysis that only included control eyes with a refraction cut-off <−3.70 D found that corneal refractive surgery was not significantly associated with glaucoma.
Conclusions History of corneal refractive surgery was associated with a higher prevalence of glaucoma in the Korean population. However, this association was not observed in eyes with a higher degree of myopia.
- Optics and refraction
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Contributors JSS and EJL drafted and revised the manuscript. EJL provided conception/design for the project. All authors provided significant effort in the analysis/interpretation of data, reviewing the manuscript, final approval of the manuscript and agreed to be accountable for all aspects of the work.
Funding This work was supported by the Seoul National University Bundang Hospital Research Fund (No. 02-2017-037) and Basic Science Research programme through the National Research Foundation of Korea (NRF) funded by the Ministry of Education, Science, and Technology (No. 2016R1D1A1B02011696). The funders had no role in the design or conduct of this research.
Competing interests None declared.
Ethics approval: human participants As all KNHANES data are anonymised and publically available, the Institutional Review Board of Seoul National University Bundang Hospital determined that this study was exempt from requiring its approval.
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement Data are available in a public, open-access repository. All data relevant to the study are included in the article or uploaded as supplemental information.