Cataract Severity Research Articles

Systemic medications and cortical cataract: the Singapore Epidemiology of Eye Diseases Study

Background/aimsTo evaluate the association between systemic medications and cortical cataract prevalence in an Asian population.MethodsThe Singapore Epidemiology of Eye Diseases Study recruited 10 033 Chinese, Malay and Indian residents aged...

Hierarchical method for cataract grading based on retinal images using improved Haar wavelet

Cataracts, which are lenticular opacities that may occur at different lens locations, are the leading cause of visual impairment worldwide. Accurate and timely diagnosis can improve the quality of life of cataract patients. In this paper, a feature extraction-based method for grading cataract severity using retinal images is proposed. To obtain more appropriate features for the automatic grading, the Haar wavelet is improved according to the characteristics of retinal images. Retinal images of non-cataract, as well as mild, moderate, and severe cataracts, are automatically recognized using the improved Haar wavelet. A hierarchical strategy is used to transform the four-class classification problem into three adjacent two-class classification problems. Three sets of two-class classifiers based on a neural network are trained individually and integrated together to establish a complete classification system. The accuracies of the two-class classification (cataract and non-cataract) and four-class classification are 94.83% and 85.98%, respectively. The performance analysis demonstrates that the improved Haar wavelet feature achieves higher accuracy than the original Haar wavelet feature, and the fusion of three sets of two-class classifiers is superior to a simple four-class classifier. The discussion indicates that the retinal image-based method offers significant potential for cataract detection.

Changes in mitochondrial cytochrome c oxidase mRNA levels with cataract severity in lens epithelia of Japanese patients.

We previously reported that the collapse of ATP production via mitochondrial damage causes ATPase dysfunction, resulting in the onset or progression of lens opacification in cataracts in model rats. In the present study, it was investigated whether the mRNA expression levels of the three subtypes of mitochondrial cytochrome c oxidase (MTCO)1, 2 and 3 and ATP content change with the type and severity of cataracts in human lens. Samples of lens epithelium were collected from Japanese patients during cataract surgery, and the type and severity of the cataracts (grade) were determined according to the WHO classification [cortical (COR), nuclear (NUC), posterior subcapsular (PSC) opacification]. The MTCO1‑3 mRNA expression levels in patients with grade‑1 COR, NUC and PSC opacification were significantly enhanced compared with those of normal patients. The enhanced MTCO1‑3 mRNA levels subsequently decreased in patients with COR, and the MTCO1‑3 mRNA levels and ATP levels in patients with grade‑3 COR were similar to those in normal patients. However, the mRNA expression levels of MTCO3 in patients with grade 3‑NUC opacification and MTCO1‑3 in patients with grade‑3 PSC opacification, along with the ATP content, were significantly lower than in patients without cataracts. In conclusion, it was revealed that ATP production in lens epithelium is enhanced in early‑stage cataracts (grade‑1) in Japanese patients with COR, NUC and PSC opacification. In addition, in severe cataracts (grade‑3), ATP production and content are strongly decreased in Japanese patients with PSC opacification. ATP depletion in human lens epithelium with PSC opacification may promote lens opacification by ATPase dysfunction.

Mitochondrial haplogroup L1c2 is associated with increased disease severity in African American patients with primary open-angle glaucoma.

The purpose of this study is to evaluate the role mitochondrial inheritance plays in primary open-angle glaucoma (POAG) characteristics in African Americans. POAG cases from the L1c2 and L1b mitochondrial haplogroups were compared in a retrospective case-case study. Twenty-six pairs of self-identified African American POAG cases from L1c2 and L1b mitochondrial haplogroups matched on age (mean [SD] = 71.2 [9.6] and 71.3 [9.6] years, respectively; p = 0.97), sex (21 female and 5 male pairs), and family history of glaucoma (positive in 15/26 [58%] pairs) were included. L1c2 subjects displayed higher vertical cup-to-disc ratio (0.75 [0.12] and 0.67 [0.16], respectively; p = 0.01, Bonferroni-corrected p = 0.08), worse pattern standard deviation on visual field (VF) testing (5.5 [3.5] and 3.5 [2.7]; p = 0.005, Bonferroni-corrected p = 0.02), and more severe glaucoma based on American Glaucoma Society staging criteria (p = 0.04, Bonferroni-corrected p = 0.32) compared to L1b subjects. L1c2 also trended towards worse mean deviation on VF compared to L1b (-8.2 [7.6] and -5.8 [6.8], respectively, p = 0.17). Best corrected visual acuity, central corneal thickness, maximum intraocular pressure (IOP), and cataract severity were comparable between L1c2 and L1b haplogroups (p ≥ 0.49), as was retinal nerve fiber layer thickness on optical coherence tomography (75.1 [14.1] and 75.1 [13.0]; p = 0.99). Results demonstrated worse glaucomatous cupping and more severe VF loss in the L1c2 compared to the L1b haplogroup despite comparable IOP. Findings implicate mitochondrial inheritance as a factor affecting POAG severity and may ultimately contribute to stratifying POAG patients into phenotypically and genotypically distinct subgroups.

Why does the zebrafish cloche mutant develop lens cataract?

The zebrafish has become a valuable model for examining ocular lens development, physiology and disease. The zebrafish cloche mutant, first described for its loss of hematopoiesis, also shows reduced eye and lens size, interruption in lens cell differentiation and a cataract likely caused by abnormal protein aggregation. To facilitate the use of the cloche mutant for studies on cataract development and prevention we characterized variation in the lens phenotype, quantified changes in gene expression by qRT-PCR and RNA-Seq and compared the ability of two promoters to drive expression of introduced proteins into the cloche lens. We found that the severity of cloche embryo lens cataract varied, while the decrease in lens diameter and retention of nuclei in differentiating lens fiber cells was constant. We found very low expression of both αB-crystallin genes (cryaba and cryabb) at 4 days post fertilization (dpf) by both qRT-PCR and RNA-Seq in cloche, cloche sibling and wildtype embryos and no significant difference in αA-crystallin (cryaa) expression. RNA-Seq analysis of 4 dpf embryos identified transcripts from 25,281 genes, with 1,329 showing statistically significantly different expression between cloche and wildtype samples. Downregulation of eight lens β- and γM-crystallin genes and 22 retinal related genes may reflect a general reduction in eye development and growth. Six stress response genes were upregulated. We did not find misregulation of any known components of lens development gene regulatory networks. These results suggest that the cloche lens cataract is not caused by loss of αA-crystallin or changes to lens gene regulatory networks. Instead, we propose that the cataract results from general physiological stress related to loss of hematopoiesis. Our finding that the zebrafish αA-crystallin promoter drove strong GFP expression in the cloche lens demonstrates its use as a tool for examining the effects of introduced proteins on lens crystallin aggregation and cataract prevention.

Accuracy of swept-source optical coherence tomography based biometry for intraocular lens power calculation: a retrospective cross\u2013sectional study

BackgroundTo evaluate the accuracy of biometric measurements by a swept-source optical coherence tomography (SS–OCT) based biometry for intraocular lens (IOL) power calculation.MethodsThis retrospective observational study enrolled 431 patients undergoing cataract surgery. The charts were reviewed to investigate the failure rate of axial length (AL) measurement of the SS–OCT biometer, partial coherence interferometry (PCI), and A–scan ultrasonography (US) according to cataract type and severity. AL and keratometry in 164 eyes with the same IOL inserted were measured using the SS–OCT biometer, PCI, and A–scan US. The SRK/T formula was used to calculate IOL power. The mean absolute error (MAE) and percentage of eyes with a prediction error (PE) of ±0.50 D were compared.ResultsThe AL measurement failure rate was 0.00% for A–scan US, 2.32% for the SS–OCT biometer, and 15.31% for PCI. The number of eyes measured using three devices (SS–OCT biometer, PCI, and A–scan US) was 128 (Group A) and the number of eyes measured using two devices (SS–OCT biometer and A–scan US) was 36 (Group B). The score of posterior subcapsular opacity was significantly different between two groups (p < .001). The SS–OCT biometer and PCI showed significantly lower MAE compared to A–scan US in Group A (p = 0.027). Using SS-OCT biometer, MAE showed no significant difference between Group A (0.36 ± 0.27) and Group B (0.36 ± 0.31) (p = 0.785). Whereas, MAE of A-scan US was significantly higher than Group A (0.47 ± 0.39) in Group B (0.64 ± 0.36) (p = 0.023).ConclusionsUsing biometry with advanced OCT is useful in clinical practice as it is more effective in obtaining biometric measurements in the eyes with PSC and provides accurate measurements for IOL power calculation regardless of cataract type and severity.Trial registrationRetrospectively registered. Registration number: KC16RISI1020. Registered 03 January 2018.

A comparative study of stereoacuity in patients with various grades of cataract and bilateral pseudophakia.

Purpose:To compare the stereopsis in patients with various grades of cataract and bilateral pseudophakia.Methods:A cross-sectional observational study was conducted at a tertiary care center in South India from December 2016 to September 2018, wherein the stereoacuity of patients having bilateral senile cataract or bilateral pseudophakia, was measured using the Titmus Fly chart. Those with any form of squint, glaucoma or retinal pathology were excluded. The patients were divided into three groups based on the severity of cataract, determined by the Lens Opacification Classification System (LOCS)-III. Group 4 included those with bilateral pseudophakia. Statistical analysis was performed using one-way ANOVA test with post hoc analysis using the Bonferroni test, to study the difference of stereoacuity between the groups.Results:A total of 200 patients were evaluated. The mean stereoacuity was 65.2 ± 18.2, 114.8 ± 83.42, 402.4 ± 223.7 and 107.2 ± 71.68 arc seconds in groups 1, 2, 3 and 4, respectively (P < 0.001). The mean best corrected visual acuity (BCVA) in LogMAR units was 0.19 ± 0.15, 0.37 ± 0.24, 0.82 ± 0.26 and 0.14 ± 0.13 in groups 1, 2, 3 and 4, respectively (P = 0.01). On comparison between four groups, there was a generalised decrease in BCVA and stereoacuity with increasing grades of cataract except for group 4 which included the bilateral pseudophakics. On post hoc analysis to analyse intergroup variation a statistically significant difference in stereo acuity was noticed when group 3 was compared to other groups.Conclusion:Stereoacuity decreases with increasing grades of cataract. Better stereoacuity is seen in patients with bilateral pseudophakia when compared with high grades of cataract.

Correlations between subjective and objective preoperative assessment of cataract severity, and intraoperative ultrasound energy

Correlations between subjective and objective preoperative assessment of cataract severity, and intraoperative ultrasound energy

Establishment of a normative database and evaluation of the test-retest repeatability of the Spaeth/Richman contrast sensitivity test.

To evaluate the test-retest repeatability of a computer-based contrast sensitivity (CS) test, the Spaeth/Richman contrast sensitivity (SPARCS) test, and to determine the effects of age and lens status on CS in normal eyes. Prospective cross-sectional study. The participants were assessed by use of the SPARCS test in each eye 3 times. The first 2 sessions were supervised, while the third was unsupervised. CS was determined for 5 areas of vision (central, superotemporal, superonasal, inferotemporal, and inferonasal) and combined to provide a total score. The test-retest repeatability was determined using Bland-Altman analysis and the intraclass correlation coefficient (ICC). The total SPARCS scores (maximum possible score = 100) ranged from 86.37 (±1.09) (for those aged 20 to 29 years) to 70.71 (±2.64) (for those aged 80 to 87 years). Individuals aged between 10 and 87 years with a normal eye examination (n = 205) were enrolled. When the SPARCS scores for the first 2 sessions were compared, the ICC was 0.79, and the repeated tests were fairly equivalent (mean difference = -0.29, P = .491). The test-retest 95% limits of agreement (95% LoA) ranged from -11.07 to +11.35. When the supervised sessions were compared with the unsupervised session, the ICC was 0.80, and there was slight improvement in the CS scores during the unsupervised session (mean difference = -1.15, P = .0001). The test-retest 95% LoA ranged from -9.18 to +10.60. The CS declined with advanced age and increased cataract severity (P <0.0001). Strong agreement was found between repeated SPARCS scores. Older age and increased lens opacity were associated with decline in CS in 5 areas of the visual field. The SPARCS test provides reliable and reproducible assessment of CS in normal eyes.

Lanosterol and 25-hydroxycholesterol dissociate crystallin aggregates isolated from cataractous human lens via different mechanisms

Cataract, a crystallin aggregation disease, is the leading cause of human blindness worldwide. Surgery is the only established treatment of cataracts and no anti-cataract drugs are available thus far. Recently lanosterol and 25-hydroxycholesterol have been reported to redissolve crystallin aggregates and partially restore lens transparency in animals. However, the efficacies of these two compounds have not been quantitatively studied ex vivo using patient tissues. In this research, we developed a quantitative assay applicable to efficacy validations and mechanistic studies by a protocol to isolate protein aggregates from the surgically removed cataractous human lens. Our results showed that both compounds were effective for human cataractous samples with EC50 values at ten micromolar level. The efficacies of both compounds strongly depended on cataract severity. Lanosterol and 25-hydroxycholesterol were two mechanistically different lead compounds of anti-cataract drug design.

Impact of social deprivation on cataract presentation and surgical outcome in the north of England: a retrospective cohort study

BackgroundSocial deprivation impacts on health outcomes but limited data on the impact on ophthalmic outcomes are available. We aimed to assess the impact of social deprivation on cataract presentation and surgical outcome. MethodsIn a retrospective, cohort study of patients undergoing cataract surgery in the North of England, we analysed the electronic patient records (Medisoft, Leeds, UK) for 24 378 patients who underwent cataract surgery at a group of ophthalmic units in the north of England between Feb 1, 2012, and Oct 31, 2017. Level of deprivation was determined by English Indices of Deprivation 2015, and outcome measures included severity of cataract (Lens Opacities Classification System), uncorrected visual acuity (UCVA) and best corrected visual acuity (BCVA) at presentation, and BCVA and subjective refractive outcome after cataract surgery. Spearman's rank correlations between social deprivation deciles and outcomes were calculated. FindingsPatients from the lowest deprivation decile presented with more severe cataracts (odds ratio 1·69 [95% CI 1·54–1·85], p<0·0001), more reduced UCVA (1·39 [1·24–1·56], p<0·0001), and more reduced BCVA (1·53 [1·37–1·72], p<0·0001) than did those from the highest deprivation decile. Patients from the least deprived decile were more likely to have a visual acuity better than 6/12 (odds ratio 2·04 [95% CI 1·51–2·76], p<0·0001) and refractive outcome within 1 dioptre of predicted (1·75 [1·31–2·34], p=0·0002) than were those from the most deprived decile. InterpretationPatients from areas of social deprivation present with poorer vision and severe cataract, so their visual outcomes are worse than those of patients from less deprived areas. Co-morbidities and education might play a role in this difference. FundingNone.

Topical nanodelivery system of lutein for the prevention of selenite-induced cataract

Cataracts are responsible for half of the world blindness, surgery being the only viable treatment. Lutein, a naturally occurring carotenoid in the eye, has the potential to reduce cataract progression by protecting the eye from photo-oxidative stress. To restore the eye's natural line of defense against photo-oxidative stress, a formulation was developed using zein and poly(lactic-co-glycolic acid) nanoparticles (NPs) embedded in an optimized bioadhesive thermosensitive gel for the delivery of lutein via topical application. Cataracts were induced in Crl:WI rats via selenite injection at 13 days post-partum, followed by 7 days of treatment with free lutein or lutein-loaded NPs administered orally or topically. Cataract severity was significantly reduced in rats treated with topical applications of lutein-loaded NPs compared to the positive control, while no significant differences were observed in rats treated with other lutein formulations including oral and topically applied free lutein.

Effects of three commercial diets on growth, cataract development and histopathology of lumpfish (Cyclopterus lumpusL.)

Three duplicate groups of individually tagged lumpfish (mean initial weight: 20.0 ± 4.0 g) were fed three commercially available diets (A, B and C) for a period of 147 days. There were significant differences in growth rates between the groups with fish fed diet A having the highest growth rates whilst fish fed diet C achieved the lowest growth. Lumpfish fed diets A and B had lower prevalence and severity of cataracts compared with fish fed diet C, suggesting a possible dietary effect on cataract, alone or in combination with other environmental factors. There was a significant difference in the degree of liver vacuolization between the three dietary treatments at the end of the study period with fish fed diets A and B showing moderate to severe vacuolization compared with liver tissue from fish fed diet C, which had milder vacuolizations. There was little or no inflammation in pyloric caeca, midgut and hindgut and similarly for epithelial necrosis or vacuolization for all three dietary treatments at the end of the study. Fish fed diet A had the longest intestinal folds whilst fish fed diet C had the shortest.

Association between cataract progression and ischemia-modified albumin in relation to oxidant–antioxidant profiles in the serum, aqueous humor, and lens

To evaluate the levels of ischemia-modified albumin (IMA) in relation to oxidant-antioxidant profiles in the serum, aqueous, and lens in cataract patients. Department of Ophthalmology, Menoufia University, Shebin El Kom, Menoufia, Egypt. Prospective case series. Patients were divided into 2 groups. The cataract (study) group comprised patients with senile cataract and the control group, age- and sex-matched healthy persons. Patients with systemic disease or cataract formation secondary to identifiable causes were excluded. In all cases, a complete history was taken and a clinical examination was performed. In the cataract group, the lens was examined, and the cataract type and severity weregraded. Blood levels of catalase, malondialdehyde (MDA), superoxide dismutase (SOD), and IMA were measured in all participants and in the aqueous and lens lysate of cataract patients. Each group comprised 30 participants. Cataract patients had significant higher levels of serum MDA and IMA than the control group but had lower levels of serum catalase and SOD. Patients with cortical cataracts had higher level of serum IMA, aqueous catalase, and SOD levels patients with nuclear cataracts but had a lower level of lens SOD. There was a significant positive correlation between serum MDA and the patient's age and serum catalase levels. Patients with cortical cataract had increased local oxidative stress and diminished antioxidant activity compared with systemic oxidative activity, which was not the same in patients with nuclear cataract.

Effect of Cataract Grade according to Wide-Field Fundus Images on Measurement of Macular Thickness in Cataract Patients.

PurposeTo investigate the effects of cataract grade based on wide-field fundus imaging on macular thickness measured by spectral domain optical coherence tomography (SD-OCT) and its signal-to-noise ratio (SNR).MethodsTwo hundred cataract patients (200 eyes) with preoperative measurements by wide-field fundus imaging and macular SD-OCT were enrolled. Cataract severity was graded from 1 to 4 according to the degree of macular obscuring by cataract artifact in fundus photo images. Cataract grade based on wide-field fundus image, the Lens Opacity Classification System III, macular thickness, and SD-OCT SNR were compared. All SD-OCT B-scan images were evaluated to detect errors in retinal layer segmentation.ResultsCataract grade based on wide-field fundus imaging was positively correlated with grade of posterior subcapsular cataracts (rho = 0.486, p < 0.001), but not with nuclear opalescence or cortical cataract using the Lens Opacity Classification System III. Cataract grade was negatively correlated with total macular thickness (rho = −0.509, p < 0.001) and SD-OCT SNR (rho = −0.568, p < 0.001). SD-OCT SNR was positively correlated with total macular thickness (rho = 0.571, p < 0.001). Of 200 eyes, 97 (48.5%) had segmentation errors on SD-OCT. As cataract grade increased and SD-OCT SNR decreased, the percentage of eyes with segmentation errors on SD-OCT increased. All measurements of macular thickness in eyes without segmentation errors were significantly greater than those of eyes with segmentation errors.ConclusionsPosterior subcapsular cataracts had profound effects on cataract grade based on wide-field fundus imaging. As cataract grade based on wide-field fundus image increased, macular thickness tended to be underestimated due to segmentation errors in SD-OCT images. Segmentation errors in SD-OCT should be considered when evaluating macular thickness in eyes with cataracts.

Analysis of changes in individual retinal layer thickness after cataract surgery using spectral‐domain optical coherence tomography

PurposeTo evaluate whether there were significant changes in macular thickness and each retinal layer thickness after cataract surgery using spectral‐domain optical coherence tomography (OCT)MethodsFrom February to August 2015, a prospective study of 24 eyes of 14 patients, who underwent cataract surgery was conducted. The thickness of each retinal layer was measured with OCT before and one month after surgery. The changes in OCT signal strength and retinal thickness before and after surgery were compared, and the layers more affected were confirmed. Also, correlation analysis was performed to determine the relationship between changes in signal strength, severity of cataract, and changes in refractive index and retinal thickness.ResultsThe mean macular thickness was significantly increased from 263.33 μm to 269.75 μm (p = 0.019). When examining the changes in each retinal layer thickness, there was a significant increase in the thickness of the inner plexiform layer (p = 0.034), outer nuclear layer (p = 0.015) and retinal pigment epithelium (RPE) (p = 0.012). The signal strength of OCT was significantly increased from 28.79 dB to 31.67 dB (p = 0.005), which was significantly correlated with postoperative macular thickness changes (p = 0.046). However, the severity of cataract (p = 0.219) or the change of refractive index (p = 0.098) was not significantly correlated with macular thickness changes.ConclusionsAfter cataract surgery, both improvement of signal strength and structural changes of the retina may increase macular thickness. In particular, the thickness of the inner plexiform layer, outer nuclear layer, and retinal pigment epithelial layer increased. Therefore, the thickness of ganglion cell‐inner plexiform layer after cataract surgery may increase, so it should be carefully considered in the assessment of glaucoma progression.

Cataract incidence and severity after therapeutic radiation for brain tumors

To determine the incidence of cataract formation and requirement for cataract surgery in a pediatric population receiving therapeutic radiation for brain tumors (SJMB03). A lower risk group (LR), without known metastasis, received 23.4 Gy and a higher risk (HR), with known metastatic disease, received 36-39.6 Gy.

Downregulation of Smac attenuates H2O2-induced apoptosis via endoplasmic reticulum stress in human lens epithelial cells.

Background:Second mitochondria-derived activator of caspases (Smac) is reported to promote apoptosis. Given the important role of apoptosis in cataract development, the aim of this study was to investigate whether Smac induces human lens epithelial cell (HLEC) apoptosis via endoplasmic reticulum stress (ERS).Methods:Smac expression was examined by immunohistochemistry in anterior lens capsules from 157 patients with age-related cataracts and 5 normal controls. The role of Smac in hydrogen peroxide (H2O2)-induced ERS and apoptosis was further evaluated using small interfering RNA knockdown in an HLEC line.Results:Notably, Smac expression was significantly higher in patients with cataracts than in controls, but showed no association with cataract severity. Cell survival was inversely correlated with H2O2 concentration, and was most significantly affected at 200 μmol/L. Moreover, flow cytometry revealed that Smac knockdown attenuated H2O2-induced apoptosis and enhanced apoptotic- and endoplasmic reticulum-related marker expression—including that of glucose-regulated protein 78, C/EBP homologous protein, caspase 3, B-cell chronic lymphocytic leukemia/lymphoma 2-associated X, and BCL2—at the gene and protein level.Conclusion:Collectively, these results indicate that Smac plays an important role in ERS-induced apoptosis in HLECs, suggesting its close association with cataract development.

An epidemiological study of cataracts in wild and farmed lumpfish (Cyclopterus lumpus L.) and the relation to nutrition.

Twelve groups of farmed lumpfish and one of wild lumpfish were screened for cataract and sampled for fish muscle tissue, whole heart and both eye lenses to investigate possible relations between cataract and tissue free amino acid concentrations. Cataract prevalence ranged from 20% to 100%, with the highest average score of 7.3 (max 8) and incidences of severe cataract (>5) in all groups. Cataract could not be explained by suboptimal histidine concentrations in the feed. Neither muscle nor cardiac tissues had concentrations of free histidine compounds. The lumpfish lens contained N-acetylhistidine (NAH), of which low concentrations were strongly related to cataract severity. However, no correlation between lens NAH and cataract severity was found in the present sample set. Wild lumpfish had higher levels compared to farmed lumpfish, suggesting that the farmed lumpfish may have been deficient in histidine or have a higher utilization of NAH due to osmotic problems. Thus, cataract in farmed lumpfish may be related to primary or secondary disturbed nutrient metabolism or malnutrition, shown by the high levels of specific amino acids in different tissues, which may cause osmotic imbalance and cataract development. This nutritional or environmental-related welfare problem deserves further research.

Association between Chronic Kidney Disease and Risk of Cataract: A Nationwide Retrospective Cohort Study

Background: Previous studies have established a relationship between chronic kidney disease (CKD) and cataract, but the relationship between the severity of renal impairment and risk of cataract is uncertain. This study investigates the relationship between the severity of renal disease and cataract in a nationwide sample from Taiwan. Methods: The cohort from 1-million National Health Insurance beneficiaries from Taiwan was retrospectively analyzed. All adult beneficiaries were followed from January 1, 2005 until December 31, 2013, to identify patients who underwent cataract surgeries. On the basis of the ambulatory care records, those diagnosed with CKD (ICD-9-CM code: 585) during the follow-up period were enrolled as CKD patients after careful evaluation. Each patient with CKD was age- and gender-matched with 4 individuals who did not have CKD. Cox regression models were applied to compare the hazard of cataract surgery in individuals with and without CKD. Subgroup analysis was used to compare patients with end-stage renal disease (ESRD) with age- and gender-matched non-CKD individuals. ESRD was defined by CKD patients who need regular renal replacement therapy. The same method was applied to evaluate hazard ratios (HRs). Results: After age and gender matching, there were 11,881 patients in the CKD group and 47,524 in the non-CKD group. After control for possible confounding, the adjusted HR (aHR) of cataract was 1.84 (95% CI 1.73-1.95) for the CKD group. Subgroup analysis of patients with ESRD (n = 3,209) and non-CKD individuals (n = 12,836), with matching done on the basis of age and gender, indicated an aHR of cataract was 2.33 (95% CI 2.10-2.59) for the ESRD group. Conclusions: This study indicates a relationship between CKD and cataract, and suggests that the risk for cataract increases with the severity of renal impairment.