Bikbov Mukharram M, Kazakbaeva Gyulli M, Panda-Jonas Songhomitra, Lakupova Ellina M, Fakhretdinova Albina A, Tuliakova Azaliia M, Jonas Jost B
Ufa Eye Research Institute, Bashkir State Medical University, Ufa, Russia.
Department of Ophthalmology, University Hospital Heidelberg, Heidelberg, Germany.
Ophthalmol Sci. 2024 May 7;4(6):100545. doi: 10.1016/j.xops.2024.100545. eCollection 2024 Nov-Dec.
To assess prevalence of cataract and cataract surgery in a very old population in Russia.
Population-based study.
The Ural Very Old Study included 1526 (81.1%) participants of 1882 eligible individuals aged >85 years.
Series of ophthalmological examinations.
Prevalence of cataract and cataract surgery.
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.
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.
The author(s) have no proprietary or commercial interest in any materials discussed in this article.
评估俄罗斯高龄人群中白内障及白内障手术的患病率。
基于人群的研究。
乌拉尔高龄研究纳入了1882名年龄大于85岁的符合条件个体中的1526名（81.1%）。
一系列眼科检查。
白内障及白内障手术的患病率。
该研究纳入了1163名（76.3%）有晶状体信息的个体。469只右眼（41.0%；95%置信区间[CI]：38.1 - 43.9）进行了白内障手术（92.1%植入后房型人工晶状体[IOL]；4.7%植入多焦点IOL），479只左眼（41.6%；95% CI：38.7 - 44.4）进行了白内障手术（92.7%植入后房型IOL；4.2%植入多焦点IOL）。610名（52.5%）个体至少一只眼进行了白内障手术。既往白内障手术较高的患病率与较低的眼压（比值比[OR]：0.92；95% CI：0.88 - 0.95）、青光眼性视神经损害分期（OR：1.20；95% CI：1.05 - 1.36）以及较好的视力（OR：0.67；95% CI：0.51 - 0.89）相关（多变量分析）。术后最佳矫正视力降至中度至重度视力损害（MSVI）的有202只眼（44.6%；95% CI：40.0 - 49.2），降至失明的有53只眼（11.7%；95% CI：8.7 - 14.7）。术后MSVI的原因是年龄相关性黄斑变性（AMD）（34.2%）、青光眼（13.9%）和后发性白内障（5.4%）。失明的原因是AMD（24.5%）、青光眼（18.9%）、角膜混浊（15.8%）和近视性黄斑变性（11.3%）。469只右眼中6只（1.3%）、479只左眼中12只（2.5%）进行了钇铝石榴石激光晶状体囊切开术。核性白内障和皮质性白内障的患病率分别为604/671（有晶状体眼为90.0%；整个研究人群为51.9%）和97.9%的眼（整个研究人群为48.4%）。白内障导致所有研究参与者中分别有28.2%（95% CI：25.6 - 30）和2.9%（95% CI：1.9 - 3.9）出现双侧MSVI和失明。
尽管白内障手术患病率相对较高，但这个来自俄罗斯的85岁以上多民族队列显示白内障相关的MSVI和失明患病率很高。术后MSVI（患病率：44.6%）和失明（患病率：11.7%）的主要原因是AMD、青光眼、角膜混浊和近视性黄斑变性。尽管术后视力良好的机会有限，但几乎所有85岁以上的个体都需要白内障手术。
作者对本文中讨论的任何材料均无所有权或商业利益。
