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Zhuoting Zhu, Lanhua Wang, Billy Heung Wing Chang, Mingguang He; The Association between Correction of Visual Impairment by Cataract Surgery and 10-year Mortality in Urban Southern China: The Liwan Eye Study. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):2115. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
There is controversy on whether cataract surgery corrected visual impairment (VI) was associated with all-cause mortality. We performed a population-based study to investigate the relationship of VI due to cataract corrected by cataract surgery at baseline to 10-year mortality in an elderly Chinese population.
In the Liwan Eye Study, of the 1864 eligible subjects aged ≥ 50 years, 1405 (75.4%) underwent comprehensive eye examinations at baseline, and a follow-up visit was arranged 10 years later. VI was defined as visual acuity less than 20/60 in the better-seeing eye according to World Health Organization(WHO) definition. Baseline cataract surgery was defined as cataract surgery completed before the baseline assessment in either eye. The details of cataract surgery were recorded. Dates of death occurring between baseline and 30th April,2014 were obtained from the National Death Index data. Information on personal income, education background and medical history were obtained from questionnaire interviews. Body mass index(BMI) was calculated as weight in kilograms divided by the square of height in meters. Cox proportional hazard regression models were used to assess the hazard ratios(HRs) and 95% confidence intervals(CIs).
A total of 791(56.3%) participants returned for the 10-year follow-up examination. While 320(22.8%) participants had died, 294(20.9%) had refused or moved away. At baseline, 195(13.9%) participants had VI attributed to cataract or had undergone cataract surgery before the baseline examination. Among them, 62(4.4%) participants underwent cataract surgery before baseline and 29(2.1%) of them had no VI. Cox proportional hazard regression analysis indicated that after adjustment for age,sex,history of diabetes and hypertension,BMI,education level and personal income, participants who underwent cataract surgery before baseline and had no VI had marginally significant increased risk of mortality, compared to participants with VI due to cataract (HR,2.27;95%CI,0.93-5.58;p=0.073).
After adjustment for age,sex,medical history and lifestyle factors,surgical correction of VI attributed to cataract was not significantly associated with all-cause mortality. This finding indicates that cataract may be a disease of aging and serve as a local marker for systemic health.
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