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Incidence of corneal ulceration and other ocular complications in a recent US military campaign.
To report the incidence of corneal ulceration and other ocular complications of refractive surgery in a recent military campaign in Afghanistan. This was a retrospective review of eye findings from all coalition military medical evacuation teams in a single military campaign in the summer of 2012. Case notes were reviewed for the incidence of corneal abrasions or ulceration among all patients examined. Logistic regression was used to calculate odds ratios (ORs) for the occurrence of complications. During the study period, 3,832 patients had eye examinations. There were 103 cases of corneal ulceration among 99 patients, a 0.65% incidence of corneal ulceration in this population. The incidence of corneal ulceration was 0.52% in those with refractive errors requiring laser treatment (N = 551), and 1.06% in those with refractive errors not requiring laser treatment (N = 4,283). Preoperative excimer laser refractive surgery was associated with a reduced odds of developing a corneal ulceration in the unadjusted analysis (OR = 0.38, 95% confidence interval [CI] = 0.14-1.07, p = 0.067). On multivariable analysis, neither excimer laser refractive surgery nor manifest refractive error predicted the development of a corneal ulceration (OR = 0.70, 95% CI = 0.18-2.78, p = 0.59; OR = 1.12, 95% CI = 0.68-1.84, p = 0.66, respectively). The frequency of post-operative complications was statistically similar to a control cohort of 500 consecutive patients at the Manchester Royal Eye Hospital. The incidence of corneal ulceration in a recent military campaign in Afghanistan is relatively high, comparable to the frequency of ocular complications following cataract surgery in a similar patient population. Refractive surgery was not found to be ac619d1d87
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