Prevalence and Associated Factors of Cataract, Cataract Surgery and Postoperative Outcome in an Old Population in Russia: The Ural Very Old Study.
Bikbov Mukharram M, Kazakbaeva Gyulli M, Panda-Jonas Songhomitra, Lakupova Ellina M, Fakhretdinova Albina A, Tuliakova Azaliia M, Jonas Jost B
AI Summary
This study found high cataract surgery rates in very old Russians, but many still had poor vision post-surgery, mainly due to AMD and glaucoma, highlighting co-morbidity challenges.
Abstract
Purpose
To assess prevalence of cataract and cataract surgery in a very old population in Russia.
Design
Population-based study.
Participants
The Ural Very Old Study included 1526 (81.1%) participants of 1882 eligible individuals aged >85 years.
Methods
Series of ophthalmological examinations.
Main outcome measures
Prevalence of cataract and cataract surgery.
Results
The study included 1163 (76.3%) individuals with lens information. Cataract surgery had been performed in 469 right eyes (41.0%; 95% confidence interval [CI]: 38.1-43.9) (92.1% with posterior chamber intraocular lens [IOL]; 4.7% with multifocal IOL) and 479 left eyes (41.6%; 95% CI: 38.7-44.4) (92.7% with posterior chamber IOL; 4.2% with multifocal IOL). Cataract surgery had been performed in at least one eye for 610 (52.5%) individuals. Higher prevalence of previous cataract surgery correlated (multivariable analysis) with lower IOP (OR: 0.92; 95% CI: 0.88-0.95), glaucomatous optic nerve damage stage (OR: 1.20; 95% CI: 1.05-1.36), and better visual acuity (OR: 0.67; 95% CI: 0.51-0.89). Postoperative best corrected visual acuity was reduced to moderate-to-severe vision impairment (MSVI) in 202 eyes (44.6%; 95% CI: 40.0-49.2) and to blindness in 53 eyes (11.7%; 95% CI: 8.7-14.7). Causes of postoperative MSVI were age-related macular degeneration (AMD) (34.2%), glaucoma (13.9%), and secondary cataract (5.4%). Causes for blindness were AMD (24.5%), glaucoma (18.9%), corneal opacifications (15.8%) and myopic macular degeneration (11.3%). Yttrium Aluminum Garnet-laser capsulotomy had been performed in 6 (1.3%) of 469 right eyes and 12 (2.5%) of 479 left eyes. Prevalence of nuclear cataract and cortical cataract was 604/671 (90.0% in phakic eyes; 51.9% in the whole study population) and 97.9% eyes (48.4% in total study population). Cataract caused bilateral MSVI and blindness in 28.2% (95% CI: 25.6-30) and 2.9% (95% CI: 1.9-3.9), respectively, of all study participants.
Conclusions
Despite a relatively high prevalence of cataract surgery, this multiethnic cohort >85 years of aged from Russia showed a high prevalence of cataract-related MSVI and blindness. Main causes for postoperative MSVI (prevalence: 44.6%) and blindness (prevalence: 11.7%) were AMD, glaucoma, corneal opacifications, and myopic macular degeneration. Almost all individuals aged 85+ years need cataract surgery, despite limited chance of postoperative good vision.
Financial disclosures: The author(s) have no proprietary or commercial interest in any materials discussed in this article.
Shields Classification
Key Concepts5
Cataract surgery had been performed in at least one eye for 610 (52.5%) individuals in a very old Russian population (Ural Very Old Study, n=1163 individuals with lens information).
In a very old Russian population (Ural Very Old Study, n=1163 individuals with lens information), higher prevalence of previous cataract surgery correlated (multivariable analysis) with lower IOP (OR: 0.92; 95% CI: 0.88-0.95) and glaucomatous optic nerve damage stage (OR: 1.20; 95% CI: 1.05-1.36).
In a very old Russian population (Ural Very Old Study, n=1163 individuals with lens information) who underwent cataract surgery, postoperative best corrected visual acuity was reduced to moderate-to-severe vision impairment (MSVI) in 202 eyes (44.6%; 95% CI: 40.0-49.2) and to blindness in 53 eyes (11.7%; 95% CI: 8.7-14.7).
In a very old Russian population (Ural Very Old Study, n=453 eyes post-cataract surgery), causes of postoperative moderate-to-severe vision impairment (MSVI) were age-related macular degeneration (AMD) (34.2%), glaucoma (13.9%), and secondary cataract (5.4%).
In a very old Russian population (Ural Very Old Study, n=453 eyes post-cataract surgery), causes for postoperative blindness were age-related macular degeneration (AMD) (24.5%), glaucoma (18.9%), corneal opacifications (15.8%) and myopic macular degeneration (11.3%).
Related Articles5
Association Between Outdoor Daylight Exposure Duration and Primary Open-Angle Glaucoma.
Cohort StudyAtrial fibrillation and flutter and ocular diseases. The Ural eye and medical study and the Ural very old study.
Cross-Sectional StudyHand grip strength and ocular associations: the Ural Eye and Medical Study.
Cohort StudyFive-year incidence of primary glaucoma and related risk factors - The Handan eye study.
Cohort StudyRisk Factors Associated With a Large Vertical Cup-to-Disc Ratio: Korean National Health and Nutritional Examination Survey.
Cross-Sectional StudyIs this article assigned to the wrong chapter(s)? Let us know.