Incidence and factors associated with incident cataract surgery in a rural population in the Indian state of Andhra Pradesh: findings from the Andhra Pradesh Eye Disease Study III.

BackgroundA large-scale prevalence survey of blindness and visual impairment (The Andhra Pradesh Eye Diseases Study [APEDS1]) was conducted between 1996-2000 on 10,293 individuals of all ages in three rural and one urban clusters in Andhra Pradesh, Southern India. More than a decade later (June 2009-March 2010), APEDS1 participants in rural clusters were traced (termed APEDS2) to determine ocular risk factors for mortality in this longitudinal cohort.Methods and FindingsMortality hazard ratio (HR) analysis was performed for those aged >30 years at APEDS1, using Cox proportional hazard regression models to identify associations between ocular exposures and risk of mortality. Blindness and visual impairment (VI) were defined using Indian definitions. 799/4,188 (19.1%) participants had died and 308 (7.3%) had migrated. Mortality was higher in males than females (p<0.001). In multivariable analysis, after adjusting for age, gender, diabetes, hypertension, body mass index, smoking and education status the mortality HR was 1.9 (95% CI: 1.5-2.5) for blindness; 1.4 (95% CI: 1.2-1.7) for VI; 1.8 (95% CI: 1.4-2.3) for pure nuclear cataract, 1.5 (95% CI: 1.1-2.1) for pure cortical cataract; 1.96 (95% CI: 1.6-2.4) for mixed cataract, 2.0 (95% CI: 1.4-2.9) for history of cataract surgery, and 1.58 (95% CI: 1.3-1.9) for any cataract. When all these factors were included in the model, the HRs were attenuated, being 1.5 (95% CI: 1.1-2.0) for blindness and 1.2 (95% CI: 0.9-1.5) for VI. For lens type, the HRs were as follows: pure nuclear cataract, 1.6 (95% CI: 1.3-2.1); pure cortical cataract, 1.5 (95% CI: 1.1-2.1); mixed cataract, 1.8 (95% CI: 1.4-2.2), and history of previous cataract surgery, 1.8 (95% CI: 1.3-2.6).ConclusionsAll types of cataract, history of cataract surgery and VI had an increased risk of mortality that further suggests that these could be potential markers of ageing.

Five-Year Incidence of Age-Related Cataract and Cataract Surgery in the Adult Population of Greater Beijing: The Beijing Eye Study

The authors aimed to assess the relation between endogenous and exogenous female hormones and the incidence of age-related cataract and cataract surgery. The Blue Mountains Eye Study examined 2,072 women aged 49 years or older during 1992-1994, of whom 1,343 (74.0% of survivors) were reexamined after 5 years, during 1997-1999. Information on reproductive factors and use of hormone replacement therapy was collected using an interviewer-administered questionnaire. Lens photographs were graded for the presence of cortical, nuclear, and posterior subcapsular cataract at baseline and follow-up. Women who had ever used hormone replacement therapy had a decreased incidence of cortical cataract affecting any eye compared with never users (odds ratio = 0.7, 95% confidence interval: 0.4, 1.0). However, this was not statistically significant (odds ratio = 0.7, 95% confidence interval: 0.4, 1.1) when using the first affected eye. Older age at menarche was associated with an increased incidence of cataract surgery (odds ratio = 2.6, 95% confidence interval: 1.2, 5.7) and a significant trend for increasing incidence of nuclear cataract (p = 0.04). There was also a significant trend for decreasing incidence of cataract surgery with increasing duration of reproductive years (p = 0.009). These epidemiologic data provide some evidence that estrogen may play a protective role in reducing the incidence of age-related cataract and cataract surgery.

Aims: To assess the 5 year incidence of cataract surgery in an older population based prospective cohort. Methods: 5 Year prospective follow up of the population based Blue Mountains Eye...

To assess the association between refractive errors and the 10-year incidence of cataract and cataract surgery. Population-based prospective study. Three thousand six hundred fifty-four persons aged 49+ years living in a well-defined geographical region were examined at baseline; 2564 were re-examined after 5 and/or 10 years. Baseline refractive error was measured using autorefraction with subjective refinement. Lens photographs were taken at each visit and assessed using the Wisconsin Cataract Grading System. Long-term incidence of cataract and cataract surgery. Compared with emmetropia, high myopia was associated with increased incidence of nuclear cataract (adjusted odds ratio 3.01, 95% confidence intervals 1.35-6.71). Low (odds ratio 1.86, confidence interval 1.03-3.35) and high myopia (odds ratio 7.80, confidence interval 3.51-17.35) were significantly associated with higher incidence of posterior subcapsular cataract. Low, moderate and high myopia were associated with increased incidence of cataract surgery (odds ratio 2.54, confidence interval 1.76-3.68; odds ratio 2.61, confidence interval 1.45-4.69; and odds ratio 4.81, confidence interval 2.33-9.93, respectively). Either any (odds ratio 1.35, confidence interval 1.08-1.69) or moderate hyperopia (odds ratio 1.76, confidence interval 1.32-2.34) was associated with increased incidence of nuclear cataract. Our longitudinal study confirms the association between myopia and an increased risk of nuclear and posterior subcapsular cataract. It also suggests that hyperopia may increase the risk of nuclear cataract.

The POLA (Pathologies Oculaires Liées à L'Age) Study is a population-based study of cataract and age-related macular degeneration and their risk factors being carried out among 2,584 residents of Sète, southern France, aged 60-95 years. Recruitment took place between June 1995 and July 1997. Cataract classification was based on a standardized lens examination by slit lamp, according to Lens Opacities Classification System III. This paper presents results obtained from cross-sectional analysis of the first phase of the study. In polytomous logistic regression analyses, an increased risk of cataract was found for female sex (cataract surgery: odds ratio (OR) = 3.03; cortical cataract: OR = 1.67), brown irises (cortical, nuclear, and mixed cataracts: OR = 1.61), smoking (cataract surgery: OR = 2.34 for current smokers and OR = 3.75 for former smokers), known diabetes of 10 or more years' duration (posterior subcapsular, cortical, and mixed cataracts and cataract surgery: OR = 2.72), use of oral corticosteroids for at least 5 years (posterior subcapsular cataract: OR = 3.25), asthma or chronic bronchitis (cataract surgery: OR = 2.04), cancer (posterior subcapsular cataract: OR = 1.92), and cardiovascular disease (cortical cataract: OR = 1.96). Decreased risk of cataract was found with higher education (all types of cataract and cataract surgery: OR = 0.59), hypertension (cataract surgery: OR = 0.57), and high plasma retinol levels (nuclear and mixed cataracts and cataract surgery: OR = 0.75 for a 1-standard-deviation increase). Most of the risk factors identified in this study confirm the findings of other studies. The association of cataract with plasma retinol level requires further investigation.

Iris color and incident cataract and cataract surgery: The Blue Mountains Eye Study

Reading performance depending on the type of cataract and its predictability on the visual outcome

Context:Globally, limited data are available on changing trends of blindness from a single region.Aims:To report the changing trends in the prevalence of blindness, visual impairment (VI), and visual outcomes of cataract surgery in a rural district of Andhra Pradesh, India, over period of one decade.Settings and Design:Rural setting; cross-sectional study.Materials and Methods:Using a validated Rapid Assessment of Cataract Surgical Services (RACSS) method, population-based, cross-sectional survey was done in a rural district in the state of Andhra Pradesh, India. Two-stage sampling procedure was used to select participants ≥50 years of age. Further, a comparative analysis was done with participants ≥50 years from the previously concluded Andhra Pradesh Eye Disease Study (APEDS) study, who belonged to the same district.Statistical Analysis:Done using 11th version of Stata.Results:Using RACSS, 2160/2300 (93.9%) participants were examined as compared with the APEDS dataset (n=521). Age and sex adjusted prevalence of blindness in RACSS and APEDS was 8% (95% CI, 6.9–9.1%) and 11% (95% CI, 8.3–13.7%), while that of VI was 13.6% (95% CI, 12.2–15.1%) and 40.3% (95% CI, 36.1–44.5%), respectively. Cataract was the major cause of blindness in both the studies. There was a significant reduction in blindness following cataract surgery as observed through RACSS (17.3%; 95% CI, 13.5–21.8%) compared with APEDS (34%; 95% CI, 20.9–49.3%).Conclusion:There was a significant reduction in prevalence of blindness and VI in this rural district of India over a decade.

Is renal impairment a predictor of the incidence of cataract or cataract surgery?: Findings from a population-based study

Incidence and Characteristics of Cataract Surgery in France from 2009 to 2012: A National Population Study

Incidence of Cataract Surgery after Vitrectomy for Vitreous Opacities

To assess the changing trends in barriers towards accessing eye care in a rural population cohort from Southern India. This is a population-based longitudinal cohort of participants (the Andhra Pradesh Eye Disease study [APEDS]) from three rural regions of Telangana and Andhra Pradesh who were evaluated at baseline (APEDS I; 1996-2000), along with follow-ups at 10 years (APEDS II; 2009-10) and 15 years (APEDS III; 2012-2016). At follow-up, all participants 30 years and above were administered a structured questionnaire on barriers to uptake of eye care services. Of 3810 participants, 1449 had visual impairment (VI). Among them, 1302 noticed a reduction in vision over last five years and 722 sought treatment, a significant improvement from baseline (P < 0.001). Participants were more likely to seek treatment if they were educated (OR = 1.43, 95%CI: 1.07-1.89), had hypertension (OR = 1.36, 95%CI: 1.04-1.77), had VI from causes other than cataract and refractive error (OR = 2.49, 95%CI: 1.56-3.99) and were residents of Adilabad (OR = 2.21; 95%CI: 1.58-3.08) and Mahbubnagar (OR = 3.55; 95%CI: 2.48-5.08) districts. Those with moderate or worse VI were less likely to seek treatment (moderate VI: OR = 0.56; 95%CI: 0.42-0.75, severe VI: OR = 0.34; 95%CI: 0.19-0.57, blindness: OR = 0.38; 95%CI: 0.2-0.73). The most important barriers to uptake of serviceswere, not perceiving loss of vision as a serious problem (25.9%), accepting it an aging process (21.4%) or due to economic reasons (16.0%). Personal and economic elements accounted for considerable amounts of barriers for utilization of eye care services. The uptake of services could be improved by addressing these specific barriers and risk factors for non-compliance.

Detailed incidence data for cataract surgery in the general population are limited, yet important for determining the surgical needs of the community and formulation of healthcare policies. To report incidence rates of cataract surgery in South Korea. Nationwide, retrospective population-based study. This study involved the entire population of South Korea (n = 47 990 761); 2 236 107 eyes of 1 591 176 patients confirmed as having cataract surgery from 1 January 2011 to 31 December 2015 were included. Data for all patients who underwent primary cataract surgery in South Korea were retrieved using Korean Electronic Data Interchange and Korean Standard Classification of Diseases-7 codes. Annual incidence rates were calculated and adjusted to the national population data for the corresponding year. The average incidence of cataract surgery during the 5-year study period was estimated using population data from the 2010 Korean census. The incidence of cataract surgery increased from 8.54/1000 person-years in 2011 to 9.67/1000 person-years in 2015. The probability of second-eye surgery within 12 months after the first-eye surgery increased from 42.98% in 2011 to 48.01% in 2015. In total, 85.72% of surgeries were performed in non-rural areas: 43.18% in individuals with a higher household income and 76.65% in primary healthcare centres. The rate of vitrectomy for posterior capsular rupture was 0.72%. The incidence of cataract surgery in South Korea is increasing over time. Our findings are expected to aid in the formulation of future healthcare policies concerning cataract surgery in South Korea.

Introduction: Prevention of visual impairment due to congenital cataract is an international priority as part of VISION 2020 - The Right to Sight, the joint initiative of the World Health Organization and the International Agency for the Prevention of Blindness. The present study is part of the Epidemiology and Safety (EPISAFE) collaborative program aiming at assessing the epidemiology and safety of interventions in ophthalmology. Methods: All children who underwent cataract surgery before the age of 1 year in France between January 2010 and December 2012 were identified by using the Programme de Médicalisation des Systèmes d'Information. Results: In 3 years, 532 children (699 eyes; 46.6% girls) had cataract surgery before the age of 1 year; 31.4% had bilateral surgery. During the first year of life, the incidence of cataract surgery was 2.15/10,000 births. The median (interquartile range) age at surgery was 3.5 (2.2-4.8) months for children with unilateral cataract and 4.0 (2.2-7.2) months for children with bilateral cataract. Of the 699 operated eyes, 76.49% received intraocular lens implantation during the cataract surgery. Conclusions: The incidence of congenital cataract surgery observed in France is close to that in the literature in the industrialized world, which is estimated at 1-3/10,000 births. The timing of surgery is critical for visual development. Surgery was performed younger in children with monocular cataracts than in those with bilateral cataracts.