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Smoking may lead to a greater risk of surgery for TED

Article

Current smokers with Graves' Disease had a greater 5-year cumulative probability, compared with patients who had never smoked, of undergoing orbital decompression.

an image of a female smoking a cigarette. (Image Credit: AdobeStock/mitarart)

Smoking was associated with an increased risk of surgical intervention for treating thyroid eye disease (TED). (Image Credit: AdobeStock/mitarart)

Researchers from the Departments of Ophthalmology Boston Children’s Hospital, and Massachusetts Eye and Ear, Harvard Medical School, Boston, reported that smoking was associated with an increased risk of surgical intervention for treating thyroid eye disease (TED) in the Intelligent Research in Sight (IRIS) Registry.1

The authors undertook a retrospective cohort study that included adults with Graves’ disease in the IRIS Registry from January 1, 2013, to December 31, 2020. The primary outcome was the need for surgery to treat TED, ie, orbital decompression, strabismus surgery, and eyelid recession surgery.

This study included 87,774 patients (mean age, 59 years;81% women).

The results showed that current smokers had a greater 5-year cumulative probability, compared with patients who had never smoked, of undergoing orbital decompression (3.7% vs 1.9%; p < 0.001), strabismus surgery (4.6% vs 2.2%; p < 0.001), and eyelid recession (4.1% vs 2.6%; p < 0.001).

After adjusting for demographic factors (age, sex, race, ethnicity, and geographic region), those who currently smoked were at greater risk of undergoing orbital decompression, strabismus surgery, and eyelid recession (p < 0.001 for all comparisons) than those who never smoked. Former smokers were at higher risk of having to undergo each of the surgeries, but the risk was lower than that associated with current smoking.

The authors concluded, “Smoking was associated with increased risk of surgical intervention for TED in the IRIS Registry. Former smokers were at a lower risk than current smokers, supporting the role of smoking cessation in lowering the burden of surgical disease at the population level.”

Reference:
  1. Oke I, Reshef ER, Elze T, et al. Smoking is associated with a higher risk of surgical intervention for thyroid eye disease in the IRIS Registry. Am J Ophthalmol. 2023;249:174-82; Published online January 19, 2023; DOI: https://doi.org/10.1016/j.ajo.2023.01.020
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