Thyroid Eye Disease

Smoking linked with increased risk of surgical intervention for TED

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Data from the IRIS Registry has determined that smoking is associated with an increased risk of surgical intervention for thyroid eye disease (TED), with former smokers at lower risk than current smokers.

This retrospective cohort study included data from 87,923 patients with Graves’ disease in the Intelligent Research in Sight (IRIS) Registry. The Kaplan-Meier estimated 5-year cumulative probability for each surgical intervention.

Below are the 5-year cumulative probability for current smokers versus never smokers:
-Orbital decompression: 3.7% vs 1.9% (P <0.001)
-Strabismus surgery: 4.6% vs 2.2% (P <0.001)
-Eyelid recession (4.1% vs 2.6% (P <0.001)

When demographic factors were adjusted for, current smokers were at greater risk of orbital decompression, strabismus surgery, and eyelid recession compared to never smokers.

Participants who were former smokers were at higher risk of each type of surgery for TED, however, participants that were current smokers remained at a higher risk.

“Former smokers were at a lower risk than current smokers, supporting the role of smoking cessation on lowering the burden of surgical disease at the population-level,” the authors concluded.

Oke I, Reshef ER, Elze T, et al; IRIS® Registry Analytic Center Consortium. Smoking is associated with a higher risk of surgical intervention for thyroid eye disease in the IRIS® Registry. Am J Ophthalmol. 2023 Jan 20:S0002-9394(23)00029-6. doi: 10.1016/j.ajo.2023.01.020. Epub ahead of print. PMID: 36690290.