Official ESCRS | European Society of Cataract & Refractive Surgeons


The association between risk factors and keratoconus for South Koreans: a 12-year nationwide cohort study

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Session Details

Session Title: Presented Poster Session: New & Interesting II

Venue: Poster Village: Pod 3

First Author: : H.Lee SOUTH KOREA

Co Author(s): :    B. Cho                       

Abstract Details


To determine whether an association actually exists between known relevant factors and keratoconus by analyzing a population-based large cohort database established from the national healthcare claim in South Korea.


A retrospective cohort study using the Korean National Health Insurance Service National Sample Cohort Database from 2002 to 2015 (NHIS-NSC 2002-2015) involving 1,108,369 individuals.


We identified patients who had been diagnosed with keratoconus from the NHIS-NSC 2002-2015 database by using Korean Standard Classification of Diseases (KCD) code H18.6, and then estimated the prevalence and annual incidence rates. For the risk factor analysis, five controls were matched per 1 keratoconus patient by age and household income. The univariable and multivariable regression analysis was performed to assess the association between the known relevant sociodemographic factors and medical conditions, and keratoconus.


613 subjects were identified as keratoconus patients. The prevalence rate was 55.31 cases per 100,000 people. The annual incidence rate calculated after an initial one-year wash-out was 4.47 cases per 100,000 person-years. For sociodemographic factors, sex and the residential area didn’t show significant association with keratoconus. For medical conditions, people with allergic conjunctivitis had a 37% increased odds of keratoconus compared to those without allergic conjunctivitis. In contrast, people with allergic rhinitis had a 52% reduced odds of keratoconus. Atopy and eczema, asthma, connective tissue disorder, diabetes mellitus, sleep apnea and inflammatory bowel disease didn’t show significant association.


For South Korean, except the ocular allergy and allergic rhinitis, we could not find any correlation between known relevant factors and keratoconus. Therefore, to determine the risk factors of keratoconus, further studies should be performed in the various ethnic groups.

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