Elsevier

Ophthalmology

Volume 115, Issue 5, May 2008, Pages 808-814.e1
Ophthalmology

Original article
Ten-Year Incidence of Age-Related Cataract and Cataract Surgery in an Older Australian Population: The Blue Mountains Eye Study

https://doi.org/10.1016/j.ophtha.2007.07.008Get rights and content

Purpose

To estimate the 10-year incidence of cataract and cataract surgery in an older Australian population.

Design

Prospective population-based study.

Participants

Persons at least 49 years old living in 2 postcode areas west of Sydney, Australia.

Methods

Eye examinations were performed at baseline and at 5- and 10-year follow-up visits. Lens photographs were taken and graded by masked graders using the Wisconsin Cataract Grading System.

Main Outcome Measures

Incidences of nuclear cataract, cortical cataract, posterior subcapsular cataract (PSC), and cataract surgery.

Results

Ten-year person-specific incidences were 36.0% for nuclear cataract, 28.0% for cortical cataract, 9.1% for PSC, and 17.8% for cataract surgery. Corresponding rates were 31.7%, 24.4%, 8.2%, and 14.4%, respectively, in men and 39.3%, 30.8%, 9.8%, and 20.1%, respectively, in women. The incidence for each type of cataract and cataract surgery was positively associated with age (P<0.0001). Women had a significantly higher incidence than men for nuclear cataract (P = 0.04), cortical cataract (P = 0.007), any cataract (P = 0.0006), and cataract surgery (P = 0.03) after adjusting for age. There was no significant gender difference for PSC. The mean age at cataract surgery was 75.8 years, and there was no significant gender difference (P = 0.9). Among persons who developed any cataract, 22% had more than one type and 1.3% had all 3 types present. Nuclear cataract and PSC were significantly associated with visual impairment (visual acuity worse than 20/40).

Conclusion

Age- and gender-specific cataract incidences in this study were similar to those reported from the U.S. Beaver Dam Eye Study. In this study, 72% of the participants were affected by cataract or had had cataract surgery over the 10-year follow-up period.

Section snippets

Study Population

Details of the BMES population and methods are reported elsewhere.2 In brief, the BMES is a population-based cohort study of vision and common eye diseases in an urban older population comprising 2 postcode areas in the Blue Mountains region, west of Sydney, Australia. This geographically well-defined area has a stable population that is reasonably representative of Australia in socioeconomic status and other measures. All residents of these 2 postcode areas who were 49 years or older were

Results

A comparison of participants and nonparticipants at each follow-up examination is summarized in Table 1 (available at http://aaojournal.org). Nonparticipants were significantly younger (P<0.0001), more likely to be smokers (P<0.0001) and to have diabetes (P = 0.049). They were also more likely to report lower health related quality of life (P = 0.041) and were less likely to live in their own home (P = 0.0006) than those who participated in follow-up examinations. Of the 2564 participants who

Discussion

Several classification and grading methods have been developed to measure the presence and extent of cataract including the Oxford,27 Wilmer,28 Lens Opacities Classification System,29, 30, 31 and Wisconsin.23 The Wisconsin Cataract Grading System was first developed in 1990 for use in the BDES. It was shown to have good reproducibility when applied to the BMES population.24

Studies that have examined cataract incidence are summarized in Table 6. These studies differ from each other in terms of

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    Manuscript no. 2006-1347.

    Supported by the Australian National Health and Medical Research Council, Canberra, Australia (grant nos. 974159, 211069).

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