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Predictors of Health Care Disparities in Fuchs Dystrophy Treatment Using the IRIS Registry
Yu Jiang1,2, Oliver Davidson1,2, Marian Blazes1,2
1Department of Ophthalmology, University of Washington, Seattle, WA.
Cornea
|January 8, 2025
Summary
Sociodemographic factors like race, sex, and age influence surgical choices for Fuchs Endothelial Corneal Dystrophy (FECD). Black patients were more likely to have PK, while older patients received less surgery overall.
Area of Science:
- Ophthalmology
- Corneal Surgery
- Health Services Research
Background:
- Fuchs Endothelial Corneal Dystrophy (FECD) is a progressive condition affecting the cornea.
- Surgical interventions like penetrating keratoplasty (PK) and endothelial keratoplasty (EK) are common treatments for FECD.
- Understanding sociodemographic influences on surgical management is crucial for equitable patient care.
Purpose of the Study:
- To investigate the association between sociodemographic factors and the type of surgical management received by patients diagnosed with FECD.
- To analyze disparities in surgical interventions for FECD based on race, ethnicity, sex, and age.
Main Methods:
- Utilized the American Academy of Ophthalmology IRIS Registry (Intelligent Research in Sight) database.
- Included patients over 40 years old diagnosed with FECD and subsequent corneal edema between 2007 and 2020.
- Employed multivariable Cox proportional hazards models to assess relationships between sociodemographic variables and time to surgery (PK or EK).
Main Results:
- Identified 20,366 patients with FECD; 4,313 underwent surgery.
- Black or African American patients showed a higher likelihood of undergoing PK compared to White patients.
- Female patients were more likely to undergo PK but less likely to have any surgery; older patients were less likely to undergo surgery with increasing age.
Conclusions:
- Sociodemographic factors, including age, sex, and race/ethnicity, are significantly associated with varying surgical management rates for FECD.
- Insurance type did not show significant differences in surgical intervention rates.
- These findings highlight potential disparities in FECD treatment that warrant further investigation and consideration for equitable healthcare delivery.
