Purpose:
To estimate the 4-year incidence of cataract surgery in Los Angeles Latinos.
Methods:
The Los Angeles Latino Eye Study is a population-based longitudinal cohort of 4,658 Latinos 40 years and older from 6 census tracts in Los Angeles, California. All participants were interviewed and examined at baseline and 4-year follow-up. Best-corrected visual acuity, slit-lamp assessment of lens opacities using the Lens Opacities Classification System II, and phakic status were recorded, along with sociodemographic and biological data such as age, gender, education level, income, and systemic and ocular comorbidities. The primary outcome was 4-year incidence of cataract surgery in either eye. Multivariate logistic regression procedures were used to determine baseline lens opacities associated with 4-year incidence of cataract surgery, after controlling for covariates; and forward stepwise logistic regression was used to identify independent risk factors associated with 4-year incidence of cataract surgery.
Results:
The 4-year incidence of cataract surgery was 3.8% (165/4384). The incidence was higher in people with older age at baseline compared to those with younger age (P<0.0001), but there was no significant association with gender. Incident cataract surgery was most strongly associated with PSC lens opacity (odds ratio [confidence interval]; 78.4 [24.3-253]) and less strongly associated with nuclear (5.5 [2.5-12]) and cortical (3.1 [1.6-6.0]) lens opacities at baseline. At 4-year follow-up, participants with PSC cataracts were most likely to have visual impairment worse than 20/40 (odds ratio [confidence interval]; 4.7 [2.9-7.4]) compared to those with nuclear (3.2 [2.2-4.4]) or cortical (1.5 [1.1-2.1]) lens opacities. Baseline independent sociodemographic and biological risk factors associated with incident cataract surgery included: age (odds ratio [confidence interval] 1.13 [1.11-1.15]) diabetes (2.18 [1.55,3.07]), intraocular pressure >21 mm Hg in affected eye (3.09 [1.60,5.96], and hyperopic spherical equivalent refractive error (continuous; 0.77 [0.72,0.82]).
Conclusions:
When compared to the literature, the incidence of cataract surgery in Los Angeles Latinos appears to be slightly higher than a Beijing Chinese population but slightly lower than previously studied Caucasian populations. Independent predictors suggest that ocular comorbidities, and thus perhaps ophthalmologist contact, may predict incident cataract surgery.
Keywords: cataract • clinical (human) or epidemiologic studies: prevalence/incidence • clinical (human) or epidemiologic studies: treatment/prevention assessment/controlled clinical trials