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G. L. Kanthan, J. J. Wang, E. Rochtchina, P. Mitchell; Factors Predicting the Long-Term Incidence of Cataract Surgery Among Older Australians With Pre-Existing Early Cataract: The Blue Mountains Eye Study. Invest. Ophthalmol. Vis. Sci. 2008;49(13):1918. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To assess factors predicting incident cataract surgery, in particular socio-economic status, in a population-based sample of older Australians with pre-existing early cataract.
3654 persons aged 49+ years were seen at baseline and 2454 were seen 5 and/or 10 years later. Lens photographs were taken at each visit, and graded using the Wisconsin System. The associations between baseline factors and 10-year incident cataract surgery were assessed.
At baseline, 700 participants had cataract, and of these, 214 underwent cataract surgery over the 10-year follow-up period. Baseline participants with either nuclear (p=0.007) or posterior subcapsular (PSC) cataract (p=0.002) were significantly more likely to have subsequent cataract surgery, compared to those with cortical cataract. Cataract surgery incidence increased significantly with age (p=0.02) but not between women and men (p=0.18). Other baseline factors associated with incident cataract surgery in this group were hypertension (p=0.02), history of current smoking (p=0.05), myopia (<0.0001), visual impairment (visual acuity < 20/40) (p=0.009) and history of falls (p=0.005). Socioeconomic status, including tertiary education level (p=0.64), job prestige index (p=0.63) and home ownership (p=0.47), however, were not predictors of incident cataract surgery. Similarly, the presence at baseline of age related macular degeneration, or a history of diabetes, angina, myocardial infarction, stroke, or poor mobility, were not associated with the long-term incidence of cataract surgery. When age, gender, cataract type, visual impairment, history of falls, smoking, and hypertension were included in a multivariate model, only age, odds ratio (OR) per 10 years of age 1.49, 95% confidence interval (CI) 1.09-2.04, presence of nuclear (OR 1.74, CI: 1.12-2.68) or PSC cataract (OR 1.80, CI: 1.03-3.15), hypertension (OR 2.10, CI: 1.23-3.57), myopia (OR 3.03, CI: 1.78-5.17), and visual impairment (OR 2.23, CI: 1.16-4.28) remained significant predictors of incident cataract surgery.
Older age, presence of myopia, visual impairment, nuclear or PSC cataract, and hypertension were predictors of subsequent cataract surgery over a 10-year period in this study population. Socioeconomic status and other co-morbidities did not significantly predict the likelihood of cataract surgery. Findings of surgery predictors were relatively similar for the whole population.
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