Tsai Tsung-Hsien, Chang Yuan-Ting, Cheng Yu-Chen
Department of Ophthalmology, Chang Gung Memorial Hospital, Keelung, Taiwan.
Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan.
Eye (Lond). 2025 May;39(7):1400-1405. doi: 10.1038/s41433-025-03662-z. Epub 2025 Feb 8.
BACKGROUND/OBJECTIVES: Cataract surgery, one of the most frequent conducted surgeries around the world, is associated with cardiovascular diseases. We aim to determine the association of cataract surgery and the risk of stroke.
Adults aged over 65 years old in the National Health and Aging Trends Study were followed 7 years annually. There were 6700 stroke-free participants included at baseline survey. These participants were divided into two groups based on past history of cataract surgery. Demographics and multiple comorbidities were compared between the two groups. We identified newly developed cases of stroke over a 7-year period and performed survival analysis. Cox regression was further performed to yield adjusted hazard ratios.
Among 6700 elderly participants, 2803 of them had a history of cataract surgery while 3897 of them had not. Over the 7-year follow-up period, the cumulative stroke-free survival rate among the cataract surgery group and the control group were 84.4% versus 88.6% (p < 0.0001, log-rank test). Compared with the control group, elderly with a history of cataract surgery had a higher risk of developing stroke (adjusted HR 1.36, 95% CI 1.03 to 1.79, p = 0.026) after adjusting for multiple covariates. Other significant predictors included age ≥80 years old, having comorbidities with heart disease, lung disease, and dementia. Contrarily, protective factors for further stroke development included higher education and more frequent outdoor activities.
Our findings suggest that patients with a history of cataract surgery had a 1.36-fold increased risk of future stroke development.
背景/目的：白内障手术是全球最常开展的手术之一，与心血管疾病相关。我们旨在确定白内障手术与中风风险之间的关联。
对国家健康与老龄化趋势研究中65岁以上的成年人进行了为期7年的年度随访。基线调查纳入了6700名无中风参与者。这些参与者根据白内障手术史分为两组。比较了两组的人口统计学和多种合并症情况。我们确定了7年内新发生的中风病例并进行了生存分析。进一步进行Cox回归以得出调整后的风险比。
在6700名老年参与者中，2803人有白内障手术史，3897人没有。在7年的随访期内，白内障手术组和对照组的累积无中风生存率分别为84.4%和88.6%（p<0.0001，对数秩检验）。与对照组相比，调整多种协变量后，有白内障手术史的老年人发生中风的风险更高（调整后的风险比为1.36，95%置信区间为1.03至1.79，p=0.026）。其他重要的预测因素包括年龄≥80岁、患有心脏病、肺病和痴呆症。相反，进一步中风发展的保护因素包括受过高等教育和更频繁的户外活动。
我们的研究结果表明，有白内障手术史的患者未来发生中风的风险增加了至1.36倍。
