Is cataract associated with cardiovascular morbidity?

Nemet, Arie Y.; Vinker, Shlomo; Levartovsky, Shmuel; Kaiserman, Igor

doi:10.1038/eye.2010.34

Cited by 37 publications

(29 citation statements)

References 29 publications

(35 reference statements)

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“…23 It is known that preoperative risk stratification with myocardial perfusion imaging provides an incremental prognostic value in intermediate-risk surgery, but not in low-risk operations. 24 We believe that the association between clinical comorbidities and cataractogenesis, 25 fear of cancellation of surgery, institutional requirements and medicolegal concerns may have contributed to the present results regarding the ordering of preoperative tests. 26 Hypertension, a minor outcome, was the most common adverse event in the current study.…”

Section: Discussionmentioning

confidence: 84%

The impact of preoperative evaluation on perioperative events in patients undergoing cataract surgery: a cohort study

Alboim

Kliemann

Soares

et al. 2016

Eye

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Purpose Ambulatory surgery is a major area of surgical and anesthetic practice, and preoperative clinics are being increasingly used for low-risk surgical procedures. This study investigated the impact of preoperative evaluation on perioperative events in patients undergoing cataract surgery. Methods This was a retrospective cohort study of 968 consecutive patients undergoing cataract surgery. Details of medical conditions, surgical, anesthetic, and postoperative information were collected from medical records. A logistic regression model was developed using propensity score adjustment for baseline characteristics. Results Out 968 patients included, 240 (24.7%) underwent outpatient preoperative evaluation. There were no perioperative major cardiovascular events. Hypertension occurred in 319 (33%) patients, accounting for 79.7% of all adverse events. Preoperative evaluation resulted in a lower hypertension rate after adjustment for propensity score (OR = 0.6; 95% CI 0.41-0.93); no effects were observed on posterior capsule rupture and emergency visits/hospitalization within 7 days of surgery. Eighty-nine patients (9.3%) had an initial systolic pressure ≥ 180 mm Hg, which was not associated with higher risk of posterior capsule rupture (P = 0.158) or postoperative adverse events (P = 0.902). Median waiting time to surgery was 6 and 2 months for evaluated and non-evaluated patients, respectively (Po0.001). Conclusions In the context of low-risk surgery and no major perioperative and postoperative outcomes, it appears that outpatient preoperative evaluation has no role in reducing adverse events in cataract surgery candidates. Despite fewer hypertensive episodes observed in evaluated patients, these episodes were not associated with any medical or surgical outcomes.

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Section: Discussionmentioning

confidence: 84%

The impact of preoperative evaluation on perioperative events in patients undergoing cataract surgery: a cohort study

Alboim

Kliemann

Soares

et al. 2016

Eye

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“…Previous studies have shown that age-related cataract is associated with systemic comorbidities [42] and general functional decline [43] in older adults. We confirmed that these systemic comorbidities and functional decline are sufficient to cause death in the general population.…”

Section: Discussionmentioning

confidence: 99%

Age-Related Cataract, Cataract Surgery and Subsequent Mortality: A Systematic Review and Meta-Analysis

Song

Sun

et al. 2014

PLoS ONE

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PurposeChanges in lens may reflect the status of systemic health of human beings but the supporting evidences are not well summarized yet. We aimed to determine the relationship of age-related cataract, cataract surgery and long-term mortality by pooling the results of published population-based studies.MethodsWe searched PubMed and Embase from their inception till March, 2014 for population-based studies reporting the associations of any subtypes of age-related cataract, cataract surgery with all-cause mortality. We pooled the effect estimates (hazards ratios [HRs]) under a random effects model.ResultsTotally, we identified 10 unique population-based studies including 39,659 individuals at baseline reporting the associations of any subtypes of cataract with all-cause mortality from 6 countries. The presence of any cataract including cataract surgery was significantly associated with a higher risk of death (pooled HR: 1.43, 95% CI, 1.21, 2.02; P<0.001; I2 = 64.2%). In the meta-analysis of 9 study findings, adults with nuclear cataract were at higher risks of mortality (pooled HR: 1.55, 95% CI, 1.17, 2.05; P = 0.002; I2 = 89.2%). In the meta-analysis of 8 study findings, cortical cataract was associated with higher risks of mortality (pooled HR: 1.26, 95% CI, 1.12, 1.42; P<0.001, I2 = 29.7%). In the meta-analysis of 6 study findings, PSC cataract was associated with higher risks of mortality (pooled HR: 1.37, 95% CI, 1.04, 1.80; P = 0.03; I2 = 67.3%). The association between cataract surgery and mortality was marginally non-significant by pooling 8 study findings (pooled HR: 1.27, 95% CI, 0.97, 1.66; P = 0.08; I2 = 76.6%).ConclusionsAll subtypes of age-related cataract were associated with an increased mortality with nuclear cataract having the strongest association among the 3 cataract subtypes. However, cataract surgery was not significantly related to mortality. These findings indicated that changes in lens may serve as markers for ageing and systemic health in general population.

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“…Another potential explanation for the association between age-related cataract and decreased survival is that age-related cataract may be a biomarker of frailty and ageing. Previous studies have reported the significant relationship between age-related cataract and comorbidities, such as atherosclerosis (Nemet et al 2010) chronic kidney disease (Wang et al 2012;Wong et al 2016) and osteoporosis (Huang et al 2018). It has been indicated that age-related cataract and systemic comorbidities may share similar underlying pathogenesis, such as oxidative stress and atherosclerosis.…”

Section: E330mentioning

confidence: 99%

Age‐related cataract and 10‐year mortality: the Liwan Eye Study

Zhu

Wang

Scheetz

et al. 2019

Acta Ophthalmologica

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Purpose: To explore the association between age-related cataract and 10-year mortality in an adult population in urban China. Methods: A total of 1405 participants aged 50 years or older were examined at baseline in the Guangzhou Liwan Eye Study. All participants were invited to attend a 10-year follow-up visit. Cataract cases were defined as either having visible lens opacity confirmed with direct ophthalmoscope under pupil dilation or previous history of cataract surgery. Visual impairment (VI) was defined as a visual acuity of 20/40 or worse in the better-seeing eye with habitual correction if worn. Body mass index (BMI) was based on anthropometric data. A brief questionnaire regarding family income, educational attainment and medical history of systemic disease was administered. Mortality rates were compared using the log-rank test and Cox proportional hazards regression models. Results: Among 1405 participants examined at baseline, 957 participants (68.1%) had visible lens opacity or history of cataract surgery. After 10 years, 320 (22.8%) participants died. The 10-year mortality rate was significantly higher in participants with cataract than in those without (30.1% versus 7.14%, log-rank p < 0.05). After adjusting for age, gender, family income, educational attainment, BMI, history of diabetes and hypertension and presence of VI, presence of cataract predicted a nearly threefold increase in the risk of mortality (HR, 2.99; 95% CI, 1.89-4.71). Conclusions: Our findings that age-related cataract is a predictor for poorer survival compared to those without may imply that cataract is a biomarker of ageing and frailty.

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Is cataract associated with cardiovascular morbidity?

Abstract: Aims To evaluate the prevalence of cardiovascular disease (CVD) and its risk factors among patients undergoing cataract surgery.

Cited by 37 publications

References 29 publications

The impact of preoperative evaluation on perioperative events in patients undergoing cataract surgery: a cohort study

The impact of preoperative evaluation on perioperative events in patients undergoing cataract surgery: a cohort study

Age-Related Cataract, Cataract Surgery and Subsequent Mortality: A Systematic Review and Meta-Analysis

Age‐related cataract and 10‐year mortality: the Liwan Eye Study

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