Incident Cataract Surgery: The Beaver Dam Eye Study

Abstract

The authors describe the incidence of cataract surgery in participants of the Beaver Dam Eye Study. Objective evidence of cataract extraction as obtained at follow-up examinations of participants of a population-based cohort is given. Participants included all adults 43 to 84 years of age who lived in the city or township of Beaver Dam, Wisconsin. Age-adjusted incidence is significantly greater for women, for those with lower diastolic blood pressure, for those with hypertension, widows/widowers, and for those who report that their vision is worse than it had been. Multivariate analyses disclose that the following characteristics (with their respective odds ratios) are significantly associated with incident cataract surgery: age (odds ratio [OR] for 10 years 1.40; 95% confidence interval [CI] 1.02, 1.91); cigarette smoking (> or = 35 pack years; OR 1.91; 95% CI 1.16, 3.17); nuclear cataract (OR 35.58; 95% CI 10.12, 125.17 at age 50 years); cortical cataract (OR 3.75; 95% CI 2.40, 5.88); posterior subcapsular cataract (OR 15.51; 95% CI 8.27, 29.09); impaired vision (OR 3.76; 95% CI 2.33, 6.05); intraocular pressure (> or = 14 mmHg; OR 2.56; 95% CI 1.50, 4.38); visual sensitivity to light (OR 1.94; 95% CI 1.19, 3.17); refractive error (myopic) (OR 1.99; 95% CI 1.22, 3.24); yellow color (OR 1.69; 95% CI 1.02, 2.81); and being examined by an ophthalmologist within 2 years (OR 1.54; 95% CI 1.03, 2.30). Many factors are associated with cataract surgery, but the prior presence of posterior subcapsular cataract is the most important lens opacity. In addition, visual function changes, which may be relatively mild, are associated with subsequent incident surgery.