Racial differences in the rates of penetrating or endothelial keratoplasty for Fuchs dystrophy among US medicare beneficiaries

Session Details

Session Title: Cornea Surgical II

Session Date/Time: Tuesday 13/09/2016 | 08:00-10:30

Paper Time: 09:10

Venue: Hall C2

First Author: : M.Mahr USA

Co Author(s): :    J. Erie   K. Baratz                 

Abstract Details

Purpose:

To determine racial differences in the rates of penetrating or endothelial keratoplasty for Fuchs dystrophy in United States Medicare beneficiaries.

Setting:

U.S. fee for service (FFS) 2014 Medicare Beneficiaries aged 65 and older.

Methods:

The U.S. Medicare Limited Dataset (5% sample of 27,163,740 FFS Medicare patients) was analyzed to determine the rate of one or more penetrating or endothelial keratoplasties (CPT codes 65730, 65750, 65755, and 65756) performed in 2014 for the diagnosis of Fuchs dystrophy (ICD-9 371.57) stratified by race (white vs black).

Results:

A diagnosis code for Fuchs dystrophy was used in 1.6% [95% CI 1.3-1.9%] of white and 1.4% [95% CI 0-2.4%] of black (P=0.76) Medicare beneficiaries who had an eye examination by an ophthalmologist in 2014. Among these patients, penetrating or endothelial keratoplasty was 1.9-fold more likely in whites compared to blacks (4.7% [95% CI 4.2-5.2%] and 2.5% [95% CI 1.1-3.9%], respectively; P<0.001). Among all corneal grafts for Fuchs dystrophy, 95% were endothelial keratoplasties, 5% were penetrating keratoplasties, 96% were in whites, and 4% in blacks out of approximately 6,500 patients undergoing 8,420 procedures for these CPT/diagnosis code pairings.

Conclusions:

In the U.S. in 2014, endothelial or penetrating keratoplasty for Fuchs dystrophy was 1.9 times more likely in whites than in blacks who had been diagnosed with Fuchs dystrophy. Future prospective studies are needed to determine reasons for this observation including racial differences in the biology of the disease, the availability of care, or other unknown factors.

Financial Disclosure:

NONE