Surgical Outcomes in Patients Diagnosed With Corneal Opacity: An IRIS (Intelligent Research in Sight) Registry Study

Corneal opacity is a leading cause of vision loss in the United States. This study examines the demographics, underlying causes, and vision outcomes of patients undergoing surgical interventions for corneal opacity.

A retrospective cohort study was conducted using data from the American Academy of Ophthalmology's Intelligent Research Insight (IRIS) Registry, which includes clinical data from 79,887,324 patients who presented to participating eye clinics between January 1, 2013, and November 30, 2020. Patients diagnosed with corneal opacity who underwent surgical procedures were identified using current procedural terminology codes. Demographic variables (age, sex, race, ethnicity), underlying causes of corneal opacity, and best-corrected visual acuity (BCVA) at diagnosis and 12 months postsurgery were analyzed. Linear regression assessed risk factors associated with worse visual outcomes.

A total of 44,073 patients underwent surgery, with a mean age of 67.24 ± 14.40 years; 55% were female. The leading indications for surgery were corneal dystrophy (39%), corneal edema (21%), noninfectious ulcers (6.4%), infectious keratitis (6.1%), and trauma (1.7%); 15% had multiple etiologies. The most common procedures included endothelial keratoplasty (62.81%), penetrating keratoplasty (31.32%), and lamellar keratoplasty (2.1%). In addition, ocular surface reconstruction procedures were performed in a few cases. BCVA improved significantly postsurgery (0.72 ± 0.68 vs. 0.56 ± 0.74 logarithm of the minimum angle of resolution; P < 0.0001). Worse outcomes correlated with poorer baseline BCVA ( P < 0.0001).

Surgical interventions significantly improve vision outcomes in patients with corneal opacity. However, poorer preoperative BCVA predicts worse postoperative outcomes, emphasizing the importance of early intervention.