Incidence and factors associated with incident cataract surgery among rural population in Southern India – Findings from the Andhra Pradesh Eye Disease Study – III

Abstract

Purpose : To report the 15-year incidence of cataract surgery and its associated factors among the rural populations in Southern India.

Methods : A population-based longitudinal cohort of individuals (The Andhra Pradesh Eye Disease Study III [APEDS III]) from three rural regions of Telangana and Andhra Pradesh (Southern Indian States) was conducted in India. Examinations were performed at baseline (APEDS I; 1996-2000), at 10 years (APEDS II; 2009-10) and 15 years (APEDS III; 2012-2016). At baseline, 7771 participants were examined 5,395 (69.4%) of whom were traced at the first follow up. All participants underwent a comprehensive assessment, including an interview for risk factors, anthropometry, blood pressure measurement, and comprehensive eye examination at baseline and at each visit using the same methods. Incident cataract surgery was defined as surgery performed in either eye during the 15-year follow-up period among participants aged 30 years and above at baseline who did not have cataract surgery at baseline.

Results : A total of 3189 participants were examined at APEDS III (30 years and above). The incidence of cataract surgery was 12.7% (95% CI; 11.7-13.8). There was a significant difference (p<0.001) in the mean age of participants who did and did not have incident cataract surgery (51.4 and 34.2 years, respectively). Univariable analysis and multivariate logistic regression analysis demonstrated a significant association between the incident cataract surgery and increasing age; 40-49 years (OR=3.9, 95% CI:2.7-5.8); 50-59 years (OR=7.9, 95% CI:5.4-11.6); 60-69 years (OR=10.9, 95% CI:6.9-17.3), diabetes mellitus (OR=3.3, 95% CI: 1.2-9.1), those with pure nuclear cataract (OR=2.3, 95% CI:1.6-3.4), pure cortical (OR=3.2, 95% CI: 1.8-5.8), pure PSC (OR=16.8, 95% CI:7.2-39.1) and mixed cataract (OR=7.4, 95% CI: 4.7-11.5). Those residing in a particular geographical area in Telangana had a lower incidence (OR=0.7, 95% CI: 0.5-1.0). Hypertension, educational status and a history of smoking remained statistically insignificant in multivariable analysis.

Conclusions : The incidence of cataract surgery was higher in older age groups and in those with diabetes and any types of cataract. Regional variation also contributed to the incidence of cataract surgery that warrant further research.

This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.