Cataract surgery and sub–type in a defined, older population: the SEECAT Project

Abstract

Abstract: : Purpose: To describe the distribution of cataract sub–types present prior to surgery among a defined population of older, bilaterally pseudophakic individuals. Methods: Subjects in the Salisbury Eye Evaluation (SEE) and their locally resident siblings underwent slit and retro–illumination photography and grading using the Wilmer Cataract Grading System. For bilaterally pseudophakic subjects, an attempt was made to determine for each eye the type(s) of cataract present prior to surgery, based on previous SEE photographs (for SEE participants) and/or medical records obtained from the operating ophthalmologist (for both SEE participants and their siblings). Results: The mean age of 223 bilaterally pseudophakic participants providing data in this study was 78.7 +/– 5.2 years, 19.3% of subjects were black and 60.1% female. The most common surgically removed cataract sub–type in this population was pure nuclear (43.5%), followed by nuclear combined with PSC (20.6%), and nuclear combined with cortical (13.9%); less common types were pure cortical (4.9%), pure PSC (4.5%), and PSC combined with cortical (2.7%). Factors such as gender and source of lens data (study photograph versus clinical record) did not significantly affect the distribution of lens opacity types, while age (PSC was more common among younger participants) and race (nuclear cataract was less common among black participants) did appear to contribute significantly to sub–type. Conclusions: Among this older, majority–white population, nuclear cataract showed a clear predominance among individuals having undergone surgery in both eyes. This may be contrasted with clinic–based studies of younger persons, which have generally found PSC cataract to predominate.

Keywords: cataract • aging • clinical (human) or epidemiologic studies: prevalence/incidence