Smoking ups risk of surgical intervention for thyroid eye disease
Smokers with thyroid eye disease are more likely to undergo surgery for their condition compared with their counterparts who do not smoke, a study has found.
The study used data from the US Intelligent Research in Sight Registry and included all adults with Graves’ disease. Researchers assessed the effect of smoking on the likelihood of a surgical intervention for thyroid eye disease, including orbital decompression, strabismus surgery, and eyelid recession surgery.
A total of 87,923 patients (median age 59 years, 81 percent women) were included in the analysis. Kaplan-Meier estimates showed that the 5-year cumulative probability for each surgical intervention was higher among current smokers than among never smokers: 3.7 percent vs 1.9 percent for orbital decompression (p<0.001), 4.6 percent vs 2.2 percent for strabismus surgery (p<0.001), and 4.1 percent vs 2.6 percent for eyelid recession (p<0.001).
Multivariable Cox regression confirmed that current smoking vs never having smoked was associated with a greater risk of orbital decompression (hazard ratio [HR], 2.1; 95 percent confidence interval [CI], 1.8–2.4; p<0.001), strabismus surgery (HR, 2.0, 95 percent CI, 1.8–2.3; p<0.001), and eyelid recession (HR, 1.7, 95 percent CI, 1.5–1.9; p<0.001).
Likewise, former smokers were at higher risk of each type of surgery for thyroid eye disease, although the level of risk was lower than that of current smokers.
The findings support the role of smoking cessation on lowering the burden of surgical disease at the population level.