Risk Of Posterior Subcapsular Cataract Research Articles

Changes in Lens Structure in Pathological Myopia, Cataract Surgery and Special Situations

Pathological myopia is a major cause of low vision and blindness worldwide. In patients with pathological myopia, there are changes such as thinning of the lens and increase in equatorial diameter. In various population and clinic-based cohort, case-control and cross-sectional studies, it has been reported that myopic patients have a higher risk of posterior subcapsular cataract, cortical and nuclear cataract. It is known that the modern technique of phacoemulsification and intraocular lens implantation is effective in highly myopic eyes and provides significant improvement in visual acuity. However, complications related to phacoemulsification such as posterior capsule rupture, retinal detachment, progression of existing maculopathy, capsular phimosis, late lens dislocation and transient intraocular pressure elevation occur more frequently in highly myopic patients. As a result, it is extremely important that cataract surgeries of these patients are performed by experienced surgeons and that attention is paid to perioperative and postoperative complications.

Risk of cataract of different morphological types in Urals population chronically exposed at low doses

ObjectiveTo assess the risk of lens opacity depending on the dose in the population exposed to external and internal radiation for a long time, based on a long-term clinical follow-up of the cohorts of people exposed to radiation as a result of two radiation accidents in the South Urals. MethodsA layer-by-layer morphological study of the lens of 1,377 exposed individuals was conducted according to a special program in the Clinical Department of the Urals Research Center for Radiation Medicine (URCRM) 68 years after the onset of exposure. Lens changes were classified in accordance with the lens opacities classification (LOCS) III and included images of lens. To calculate the doses to lens, the data were taken into account, including the person's residence history in the radioactively contaminated territory, age and sex that affected their lifestyle and diet, radionuclide distribution in organs and tissues. Individualized lens doses were calculated using Techa River Dosimetry System (TRDS)-2016. Case-control method was used for statistical analysis. ResultsIndividual values of absorbed dose to lens ranged from 0 to 600 ​mGy. A dose-dependent increased risk of posterior subcapsular cataract (PSC) (OR ​1.54, 95%CI: 1.04–2.27) and nuclear cataract (OR ​1.84, 95%CI: 1.14–2.95) was found among chronically exposed individuals by a case-control method. No evidence of dose effect was found for cortical cataracts. ConclusionsThe results showed that population exposed to long-term chronic low-dose radiation was subjected to an increased risk of PSC and nuclear cataract development.

The role of oxygen and the Goldilocks range in the development of cataracts induced by space radiation in US astronauts

This article explores the role that oxygen levels in US spacecraft from 1961 to 1998 have on the development of cataracts induced by space radiation in astronauts and whether oxygen levels are well accounted for in experimental studies examining cataractogenesis. The first epidemiological report in 2001 linked an increased risk of the primary types of cataracts, and nuclear cataract alone, for astronauts with higher lens doses. However, later studies of US astronauts in 2009 and 2012 reported a higher risk of cortical cataract and posterior subcapsular cataract, but not for nuclear cataract. Firstly, it is postulated that the high oxygen level atmospheres of spacecraft employed before 1976 were a factor in promoting nuclear cataract. The high oxygen levels of hyperbaric oxygen therapy are reportedly associated with nuclear cataract, and the low intraocular oxygen levels of diabetic patients are possibly linked to their higher risk of posterior subcapsular cataract and cortical cataract. Secondly, it is hypothesized that the normal hypoxic environment of the lens and lens epithelial cells (LECs), and all stem/progenitor cells in general, have an optimal Goldilocks range of oxygen levels. Too high a lenticular oxygen level increases oxidative stress and radiosensitivity due to the oxygen effect. Whereas too low an oxygen tension also increases oxidative stress and disrupts LEC differentiation. Even so, a focused literature search of the PubMed database of in vitro experiments with LECs shows that studies rarely account for the hypoxic state of the normal lens, whether ionizing radiation is a factor or not. It is therefore recommended that ocular physioxic levels should therefore be considered when designing in vitro studies to better understand the progression of cataractogenesis on long-duration missions to the Moon and Mars.

Eye lens opacities and cataracts among physicians and healthcare workers occupationally exposed to radiation: A systematic review and meta-analysis.

To evaluate the risk of developing eye lens opacities and cataracts among physicians and healthcare workers occupationally exposed to radiation. Our literature search captured articles published in Embase, Web of Science, PubMed, Cochrane Library, Cumulative Index to Nursing and Allied Health Literature, and Google Scholar databases until September 2021. Then, we retrieved articles reporting cataracts and eye lens opacities induced by radiation exposure among healthcare professionals. The outcomes of interest were cataracts, nuclear opacity, cortical opacity, posterior subcapsular opacity, and any lens opacity. Of the 4123 articles identified, 15 studies met the inclusion criteria. Healthcare workers exposed to radiation had a significantly greater risk of posterior subcapsular cataracts (PSCs), cataracts, and any lens opacities than those of the non-exposed participants (p<0.05). The cortical opacity was not significantly different between the exposed and non-exposed participants (p>0.05). Radiation was not determined to be a risk factor for nuclear opacity as it was significantly greater in the control group than the exposed participants. Subgroup analysis revealed that nurses had the highest risk for PSCs (risk ratio = 4.00), followed by interventional cardiologists (risk ratio = 3.85). The risk of posterior subcapsular opacities and cataracts is significantly higher in healthcare workers with occupational radiation exposure than in non-exposed workers, highlighting the necessity to enhance and promote the wearing of protective measures with high safety levels.

Inhaled corticosteroids: Ocular safety and the hypothalamic-pituitary-adrenal axis

BackgroundInhaled corticosteroids (ICSs) effectively deliver corticosteroids to target sites in the lungs and reduce systemic effects compared with oral corticosteroids, but long-term systemic exposure from inhaled corticosteroids remains a concern. ObjectiveTo discuss ICS systemic effects on the eye and the hypothalamic-pituitary-adrenal (HPA) axis. MethodsRelevant publications were used to augment discussion. ResultsThe most common adverse effects of exogenous corticosteroids on the eye are secondary open-angle glaucoma and posterior subcapsular cataracts. Study findings conflict about whether ICS use is associated with increased risk of glaucoma or elevated intraocular pressure, but studies might not have addressed the question in the right population. Increased risk of glaucoma may be limited to a few susceptible individuals, such as individuals with a family history of glaucoma. Large population-based studies reveal that high daily doses or high lifetime exposure of ICSs is associated with a higher risk of posterior subcapsular cataracts. More research is needed to determine the risk from low to moderate doses during long periods. For the HPA axis, there are several measures for detecting systemic effects. Short-term measures are more sensitive for detecting the systemic effects of ICSs but have less predictive value in identifying clinically important adverse effects. Several studies have found that ICSs have a dose-dependent effects on cortisol suppression that can be used to estimate equivalent dosages among ICSs. ConclusionBecause of systemic effects on the HPA axis, high doses of ICS should be avoided where possible. Adult patients undergoing high-dose or long-term ICS therapy should be monitored for cataracts.

Is there association between Glutathione S Transferases polymorphisms and cataract risk: a meta-analysis?

BackgroundGlutathione S transferase (GST) polymorphisms have been considered as risk factors for age-related cataracts, but the results remain controversial. In this study, we have performed a meta-analysis to evaluate the association between polymorphisms of GSTM1 and GSTT1 and cataract risk.MethodsPublished literature from PubMed and other databases were retrieved. The case–control studies regarding the association between GSTM1 or GSTT1 polymorphism and cataract risk were included. Pooled odds ratio (OR) and 95 % confidence interval (CI) were calculated using random- or fixed-effects model.ResultsFifteen studies on GSTM1 (3,065 patients and 2,105 controls), and nine studies on GSTT1 (2,374 patients and 1,544 controls) were included. By pooling all the studies, GSTM1 null polymorphism was not associated with cataract risk, and this negative association maintained in subgroup analyses. However, GSTT1 null polymorphism was significantly associated with increased risk of posterior subcapsular (OR, 1.42; 95 % CI, 1.04–1.94) but not other subtypes of cataract. Stratified analyses demonstrated an association of GSTT1 null genotype with increased risk of cataract in Asian (OR, 1.44; 95 % CI, 1.14–1.83) but not Caucasian populations. In addition, seven pooled studies showed no association of cataract risk with the combined GSTM1 and GSTT1 null genotypes.ConclusionsThis meta-analysis suggests that GSTT1 null polymorphism is associated with increased risk of posterior subcapsular cataract. Given the limited sample size, the association between GSTT1 null polymorphism and cataract risk in Asian awaits further investigation.

Nutrition Effects on Ocular Diseases in the Aging Eye

We reviewed the data from the clinical trials of nutritional supplements for the treatment of age-related cataract and age-related macular degeneration (AMD) to determine future directions of research and treatment. Data from the controlled clinical trials are presented and reviewed for potential opportunities for further research into the treatment of cataracts and AMD. Two trials using daily multivitamins/minerals demonstrated a reduction in the progression of nuclear cataract, but increased the risk of posterior subcapsular cataract. For AMD, the Age-Related Eye Disease Study (AREDS) formulation (vitamins C, E, beta-carotene, zinc, and copper) reduced the risk of progression to advanced AMD by 25% at 5 years. Because beta-carotene is associated with increased lung cancer in former smokers, lutein/zeaxanthin could replace beta-carotene and provide an incremental increase in the beneficial effects beyond the effects of the AREDS formulation. In addition, a randomized clinical trial of B vitamins demonstrated a beneficial effect for AMD with the vitamin B complex. Future evaluation may include additional assessments of nutrients for the treatment of progression of cataract and AMD. A modest reduction would have significant impact as the numbers of persons affected with these two leading causes of blindness are projected to double in the next decade. An important step would be to develop surrogate outcomes to increase efficiency in clinical trials. More detailed phenotyping, especially of AMD, is required as it appears to be not one disease, but a group of diseases. Genotype-phenotype analyses may help to target pathways that are important in AMD.

A review of non-cancer effects, especially circulatory and ocular diseases

There is a well-established association between high doses (>5Gy) of ionizing radiation exposure and damage to the heart and coronary arteries, although only recently have studies with high-quality individual dosimetry been conducted that would enable quantification of this risk adjusting for concomitant chemotherapy. The association between lower dose exposures and late occurring circulatory disease has only recently begun to emerge in the Japanese atomic bomb survivors and in various occupationally exposed cohorts and is still controversial. Excess relative risks per unit dose in moderate- and low-dose epidemiological studies are somewhat variable, possibly a result of confounding and effect modification by well-known (but unobserved) risk factors. Radiation doses of 1Gy or more are associated with increased risk of posterior subcapsular cataract. Accumulating evidence from the Japanese atomic bomb survivors, Chernobyl liquidators, US astronauts, and various other exposed groups suggests that cortical cataracts may also be associated with ionizing radiation, although there is little evidence that nuclear cataracts are radiogenic. The dose-response appears to be linear, although modest thresholds (of no more than about 0.6Gy) cannot be ruled out. A variety of other non-malignant effects have been observed after moderate/low-dose exposure in various groups, in particular respiratory and digestive disease and central nervous system (and in particular neuro-cognitive) damage. However, because these are generally only observed in isolated groups, or because the evidence is excessively heterogeneous, these associations must be treated with caution.

Interventional cardiologists and risk of radiation-induced cataract: Results of a French multicenter observational study

BackgroundInterventional cardiologists (ICs) are exposed to X-rays and may be at risk to develop cataract earlier than common senile cataract. Excess risk of posterior subcapsular cataract, known as radiation-induced, was previously observed in samples of ICs from Malaysia, and Latin America. The O'CLOC study (Occupational Cataracts and Lens Opacities in interventional Cardiology) was performed to quantify the risk at the scale of France. MethodsThis cross-sectional multicenter study included an exposed group of ICs from different French centers and an unexposed control group of non-medical workers. Individual information was collected about cataract risk factors and past and present workload in catheterization laboratory. All participants had a clinical eye examination to classify the lens opacities (nuclear, cortical, or posterior subcapsular) with the international standard classification LOCS III. ResultsThe study included 106 ICs (mean age=51±7years) and 99 unexposed control subjects (mean age=50±7years). The groups did not differ significantly in the prevalence of either nuclear or cortical lens opacities (61% vs. 69% and 23% vs. 29%, respectively). However, posterior subcapsular lens opacities, were significantly more frequent among ICs (17% vs. 5%, p=0.006), for an OR=3.9 [1.3–11.4]. The risk increased with duration of activity but no clear relationship with workload was observed. However, the risk appeared lower for regular users of protective lead glasses (OR=2.2 [0.4–12.8]). ConclusionsICs, in France as elsewhere, are at high risk of posterior subcapsular cataracts. Use of protective equipment against X-rays, in particular lead glasses, is strongly recommended to limit this risk.

Incidence and Risk Factors for Posttransplant Subcapsular Cataract: A Long-Term Retrospective Cohort Study

Background The occurrence and risk factors for posterior subcapsular cataract (PSC) after renal transplantation have received little attention. Objectives To analyze the cumulative incidence of PSC after renal transplantation and identify risk factors for the development of PSC. Methods Retrospective review of the records of the patients who underwent kidney transplantation between May 1986 and December 2008. Results We included 94 renal transplant recipients who showed PSC incidence at 5, 10, and 15 years of 3.5%, 40.5%, and 50.1%, respectively. Cumulative incidence of PSC during the follow-up was 37.2%. On multivariate analysis, age, body mass index (BMI) and cumulative corticosteroid dose were significantly associated with PSC. Recipient age above 50 years (hazard ratio [HR] = 2.88, 95% confidence interval [CI]: 1.42–5.83; P = .003), BMI above 25 kg/m 2 (HR = 2.28, CI: 1.09–4.78; P = .029), and prednisolone dose above 3 mg/kg/mo (HR = 7.79, CI: 3.34–18.99; P < .001) were independent risk factors for PSC. Diabetes, renal diagnosis, duration, and type of dialysis and posttransplant immunosuppressive regimen did not influence the occurrence of PSC. Conclusion The risk of PSC was low during the first years after transplantation reaching a plateau at 15 years posttransplantation. Among the risk factors for PSC, cumulative corticosteroid dose and body weight were the only modifiable risk factors.

Treatment For A Mean Of 16 Years With Inhaled Budesonide In Children With Asthma: Effect On Intraocular Pressure And Occurrence Of Cataracts

RATIONALE: Most studies assessing the risk of posterior subcapsular cataract (PSC) development in association with oral or inhaled steroid use have been cross-sectional; here, the risk of PSC development was assessed in budesonide-treated asthma patients followed longitudinally through childhood into adulthood.

Prevalence of posterior subcapsular cataracts in volunteer cytapheresis donors

Granulocyte donors routinely receive dexamethasone orally before donation. Steroids may increase the risk of posterior subcapsular cataract (PSC) formation. We recruited 100 granulocyte donors (four or more granulocyte donations; any number of platelet [PLT] donations) and 100 age- and sex-matched PLT donors (zero to three granulocyte donations, any number of PLT donations) to examine the risk of PSC. PSC was assessed by a masked ophthalmologist and reading center lens photograph gradings or medical record documentation of PSC as the reason for cataract extraction. Fourteen eyes of 10 granulocyte donors and five eyes of four PLT donors had PSCs (odds ratio [OR], 2.82; 95% confidence interval [CI], 0.83-9.61; p = 0.10). Risk of PSC increased with number of granulocyte donations: compared to zero to three donations (4.0%), the risk for four to nine, 10 to 19, and 20 or more donations was 8.6% (OR, 2.25; 95% CI, 0.31-13.99; p = 0.30), 9.5% (OR, 2.53; 95% CI, 0.44-14.20; p = 0.21), and 13.0% (OR, 3.60; 95% CI, 0.48-22.81; p = 0.11), respectively (p = 0.06 for trend). We did not demonstrate a statistically significant increased risk of PSC associated with granulocyte donation. However, although this makes a large risk unlikely, we cannot rule out a small to moderate risk and there is biologic plausibility that the steroid administration associated with granulocyte donation could be associated with PSC formation. Transfusion medicine professionals should advise granulocyte apheresis donors to maintain an appropriate frequency of eye examinations.

Cataracts in neutrophil donors stimulated with adrenal corticosteroids.

A relatively young man (43 years old) was found to have a cataract after receiving prednisone before each of 35 neutrophil (PMN) donations over several years. Because corticosteroids are known to induce posterior subcapsular cataracts (PSCs), additional repeat PMN donors were examined ophthalmologically. A controlled, blinded study was performed in 11 PMN donors who received prednisone with or without G-CSF before 17 to 46 leukapheresis donations over an average of 8.5 years. Control subjects were nine plateletpheresis donors of comparable age and donation experience, but they had never donated PMNs. A complete eye examination was performed by an ophthalmologist who was unaware of the donor's status (PMN vs. platelet). Mild PSCs were found in 36 percent (4/11) of PMN donors versus 0 of 9 platelet donors (p = 0.068). Five of the 22 PMN donor eyes involved versus 0 of the 18 platelet donor eyes involved exhibited PSCs (p = 0.040). Cortical and nuclear cataracts were found similarly in both groups of donors (82% PMN vs. 56% platelet donors; p = 0.217); this indicated that lifestyle factors, independent of corticosteroids, that might predispose to cataract formation probably were comparable. Corticosteroids given before PMN donations by leukapheresis might increase the risk of PSCs. Because of widespread renewed interest in PMN transfusions, this potential risk factor--if confirmed by studies of additional PMN donors--is of great international importance. Other centers are urged to perform ophthalmologic examinations on repeat PMN donors to clarify this issue.

Plasma antioxidant vitamins and carotenoids and age-related cataract

Objective To investigate the relationships between plasma concentrations of antioxidant vitamins and carotenoids and nuclear, cortical, and posterior subcapsular cataracts in a group of elderly men and women. Design Cross-sectional survey. Participants Three hundred seventy-two men and women, aged 66 to 75 years, born and still living in Sheffield, England. Methods The Lens Opacities Classification System (LOCS) III was used to grade nuclear, cortical, and posterior subcapsular lens opacities. Fasting blood samples were taken to assess plasma concentrations of vitamin C, vitamin E, α-carotene, β-carotene, lycopene, lutein, zeaxanthin, and β-cryptoxanthin. Main outcome measures Logistic regression analyses of the associations between plasma vitamin concentrations and cataract subtype, adjusting for age, gender, and other risk factors. Results After adjustment for age, gender, and other risk factors, risk of nuclear cataract was lowest in people with the highest plasma concentrations of α-carotene (odds ratio [OR], 0.5; 95% confidence interval [CI], 0.3–0.9, P for trend 0.006) or β-carotene (OR, 0.7; 95% CI, 0.4–1.4, P for trend 0.033). Risk of cortical cataract was lowest in people with the highest plasma concentrations of lycopene (OR, 0.4; 95% CI, 0.2–0.8, P for trend 0.003), and risk of posterior subcapsular cataract was lowest in those with higher concentrations of lutein (OR, 0.5; 95% CI, 0.2–1.0, P for trend 0.012). High plasma concentrations of vitamin C, vitamin E, or the carotenoids zeaxanthin and β-cryptoxanthin were not associated with decreased risk. Conclusions These findings suggest that a diet rich in carotenoids may protect against cataract development, but because they are based on observational data, they need to be confirmed in randomized controlled trials.

Dietary sodium intake and cataract: the Blue Mountains Eye Study.

A population-based cross-sectional study (n = 2,873) was conducted near Sydney, Australia, from January 1992 to January 1994 to assess the relation between dietary sodium intake and risk of cataract. Photographs of subjects' lenses were graded for cortical, nuclear, and posterior subcapsular cataracts. Dietary sodium intake was assessed with a food frequency questionnaire. The study found that higher sodium intakes were associated with greater risk of posterior subcapsular cataract (p for trend = 0.006). The adjusted relative risk was 2.0 (95% confidence interval: 1.2, 3.4) for subjects in the highest versus the lowest quintile of sodium intake. These findings suggest that a high-salt diet may increase the risk of posterior subcapsular cataract.

Inhaled Corticosteroids and Cataract

Oral and topical (ocular) corticosteroids are known to have the potential to cause cataracts, but inhaled corticosteroids have generally been considered to be free of this adverse effect. However, a large epidemiological study has recently found a strong association in adults between use of inhaled corticosteroids and risk of posterior subcapsular cataract, the most serious type of cataract. This is likely to be a causal association as the association was strong (odds ratio of 10 for heavy users of corticosteroids compared with nonusers); in addition, there was a dose-response relationship and the association is biologically plausible. For people with asthma, the benefits of inhaled corticosteroids for management of their respiratory symptoms will be much greater than the risk of cataract. This is particularly true for children, in whom the risk of cataract is extremely low. Nevertheless, the existence of serious adverse effects of inhaled corticosteroids means they should be used for the shortest duration, and in the lowest dose, compatible with effective asthma management.

Evaluation of Intraocular Pressure and Cataract Formation following the Long-Term Use of Nasal Corticosteroids

It is possible that corticosteroids administered via nasal spray might reach ocular structures in levels sufficient to provoke an ocular hypertensive response and cause posterior subcapsular cataracts (PSCs) in susceptible individuals. In the present study, 26 patients who had undergone endoscopic sinus surgery were evaluated prospectively with respect to intraocular pressure and PSC formation following the use of nasal steroids for at least three months. Eighteen patients (69%) self-administered 200 micrograms/day of budesonide nasal spray twice daily, and eight patients (31%) self-administered 200 micrograms/day of beclomethasone dipropionate nasal spray twice daily, for a period of three to 19 months (mean 8.8 +/- 3.6 months). Ophthalmologic examination, tonometry, visual field testing and biomicroscopic studies revealed no evidence of ocular hypertension or PSCs during postoperative follow-up. We conclude that intranasal corticosteroids can be used safely for prolonged periods without increasing the risk of ocular hypertension or PSCs.

Low-dose aspirin and risk of cataract and subtypes in a randomized trial of U.S. physicians

PURPOSE: To examine whether low-dose aspirin (325 mg on alternate days) reduces the risk of age-related cataract and subtypes. This report extends previous findings, including both subtypes and additional newly identified incident cases since the earlier report. METHODS: All 20,979 participants in the Physicians' Health Study, a randomized trial of aspirin and beta-carotene among U.S. male physicians age 40-84 in 1982, who did not report cataract at baseline were included. Average follow-up was five years. The main outcome measure was incident, age-related cataract responsible for a reduction in best-corrected visual acuity to 20/30 or worse, based on self-report confirmed by medical record review. RESULTS: 501 age-related cataracts were diagnosed during follow-up, including 416 with nuclear sclerosis and 212 with a posterior subcapsular component; 318 cataracts progressed to surgical extraction. Overall, there were 245 cataracts in the aspirin group and 256 in the placebo group (relative risk [RR], 0.94; 95% confidence interval [CI], 0.79 to 1.13; P=0.52). Cataract extractions were 19% less frequent in the aspirin than in the placebo group (RR, 0.81; 95% CI, 0.65 to 1.01; P=0.06). In subgroup analyses of subtypes, aspirin takers had a lower risk of posterior subcapsular cataract (RR, 0.74; 95% CI, 0.57 to 0.98; P=0.03) but not nuclear sclerosis (RR, 0.96; 95% CI, 0.79 to 1.16; P=0.65) cataract. CONCLUSIONS: Overall, these randomized trial data tend to exclude a large benefit of five years of low-dose aspirin therapy on cataract development and extraction. The data are compatible with a modest benefit on cataract extraction for this duration of aspirin therapy. Subgroup analyses raise the possibility of a modest, but potentially important, protective effect of aspirin on posterior subcapsular cataract, a particularly disabling subtype.

HIGH-DOSE INHALED STEROIDS

Most guidelines presently recommend high-dose inhaled steroids (1000 µLg/d or more) as first-line maintenance therapy for moderate to severe asthma. Numerous studies have established the superiority of high-dose inhaled steroids over placebo in reduction or discontinuation of oral steroids and improvement of symptoms and objective lung function. It is surprising to note, however, that the studies of the doseresponse relationship have not shown consistent or conclusive results. This discrepancy in results is most likely due to varying study designs. The inhaled steroid preparations currently available appear to have comparable efficacy with only slight differences. Newer non-CFC delivery systems may improve bronchial delivery. High-dose inhaled steroids appear to cause HPA suppression and to affect bone metabolism to a mild degree with no clear clinical correlation at this time. Long-term studies of these effects are ongoing. There may be a beneficial effect of inhaled steroids on insulin sensitivity and glucose tolerance. Dermal thinning and purpura have been reported. The risk of posterior subcapsular cataracts is minimal. Local effects are mild and reversible and include dysphonia, oral candidiasis, and reflex cough. The use of delivery devices such as spacers and holding chambers improves delivery to the lungs and decreases the incidence of local side effects and systemic absorption. The risk/benefit ratio of high-dose inhaled steroids is excellent based on current data, and these medications should continue to be used as primary maintenance therapy in patients with moderate to severe asthma.

Alcohol use and risk of posterior subcapsular opacities.

We conducted a follow-up study of surgical cases of posterior subcapsular cataracts and their controls to evaluate the possible association of alcohol intake and posterior subcapsular opacities. Two hundred thirty-eight cases and controls were interviewed. Current alcohol intake and usual and maximum weekly consumption ever were assessed. In this population, 57% of the cases and 56% of the controls were nondrinkers, 22% of the cases and 36% of the controls had an average of seven or fewer drinks per week, and 17% of the cases and 8% of the controls had more than seven drinks per week. A matched pair analysis controlling for other known risk factors showed an increased risk associated with heavy alcohol use. Heavy drinkers were more likely to be cases than were nondrinkers (odds ratio, 4.6; P < .05), and light drinkers were not at an increased risk. This result suggests that heavy alcohol consumption may increase the risk of posterior subcapsular cataract.