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G. L. Kanthan, J. J. Wang, E. Rochtchina, A. G. Tan, E.-M. Chia, A. Lee, P. Mitchell, Blue Mountains Eye Study; Ten-Year Incidence of Age-Related Cataract and Cataract Surgery in an Older Australian Population: The Blue Mountains Eye Study. Invest. Ophthalmol. Vis. Sci. 2007;48(13):5675.
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To estimate the 10-year incidence of cataract and cataract surgery in an older Australian population.
Persons aged 49+ years living in two postcode areas, west of Sydney, Australia were invited to participate in the Blue Mountains Eye Study. 3654 (82.4% of the eligible) participants were seen at baseline (1992-4) and 2454 were seen after 5- and/or 10-years. Eye examinations were performed and lens photographs were taken at baseline and at each follow-up visit. These photographs were graded in a masked fashion using the Wisconsin Cataract Grading System. Intergrader and intragrader reproducibility of lens grading was assessed using quadratic weighted kappa statistics and ranged from 0.52 to 0.92, indicating acceptable reproducibility.
The 10-year person-specific incidence was 36.0% for nuclear, 28.0% for cortical and 9.1% for posterior capsular (PSC) cataract, and 17.8% for cataract surgery. Corresponding rates were 31.7%, 24.4%, 8.2%, and 14.4%, respectively, in men and 39.3%, 30.8%, 9.8% and 20.1%, respectively, in women. The incidence for each type of cataract and cataract surgery was increased strongly with age (p<0.0001). The female excess in cataract incidence was significant for all three types of cataract and for cataract surgery, after adjusting for age (p<0.0001). Among persons who developed any cataract, 22% had more than one type and 1.3% had all three types. The incidence of both nuclear and PSC cataract was a significant predictor of visual impairment (corrected visual acuity worse than 20/40) presented at the time of examinations. The mean age at cataract surgery was 75.8 years and there was no significant gender difference (p=0.88). Of participants with nuclear, cortical or PSC cataract in the right eye at baseline, 32.5%, 26.8% and 40.9%, respectively, underwent cataract surgery in that eye during the subsequent 10-year period.
The age- and gender-specific cataract incidence in this study was similar to that reported by the Beaver Dam Eye Study. We found that almost three-quarters (72%) of persons aged 49 or older, developed one or more types of cataract or required cataract surgery over a 10-year follow-up period. Cataract and cataract surgery thus clearly represent a substantial public health burden in the current aging population.
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