Epidemiology and risk factors for corneal blindness in China: a multicentre retrospective study of 15,937 inpatients

To describe the demographic and clinical characteristics of inpatients with corneal blindness in China and identify independent risk factors.

This multicentre, retrospective, observational study was conducted by 16 clinical centres in 15 provincial-level administrative regions across China. Inpatients discharged with a primary diagnosis of corneal disease between January 1, 2019, and December 31, 2021, were included. The demographic and clinical characteristics of patients with corneal blindness were evaluated, and risk factors were identified via multivariate regression analysis. Regional variations in the corneal blindness and keratoplasty rates were also assessed.

A total of 15,937 patients with corneal diseases were analysed; 9272 of these patients (58.18%) had corneal blindness. Most patients were male (6614 [71.33%]), with a median age of 55 years (IQR 45-66). The most common types of corneal blindness were keratitis (5141 [55.45%]) and corneal injury (3153 [34.01%]). Multivariate regression analysis revealed that male sex (aOR 1.171, 95% CI 1.081-1.268), older age (aOR 1.021, 95% CI 1.019-1.024), rural residence (aOR 1.348, 95% CI 1.254-1.448), lack of medical insurance (aOR 1.215, 95% CI 1.123-1.314), living in the western region (aOR 1.247, 95% CI 1.152-1.350) and having coexisting glaucoma (aOR 2.288, 95% CI 1.890-2.768) were risk factors for corneal blindness. The western region had the highest percentage of corneal blindness cases (p < 0.001, 61.23%) but the lowest percentage of keratoplasty cases (p < 0.001, 24.68%).

The study on identifying risk factors for corneal blindness provides evidence for optimising clinical decision-making and may contribute to reducing the incidence of corneal blindness.