Refractive errors and incident cataracts: the Beaver Dam Eye Study.
OBJECTIVE
To describe the relation between refractive errors and incident age-related cataracts in a predominantly white US population.


METHODS
All persons aged 43 to 84 years of age in Beaver Dam, Wisconsin, were invited for a baseline examination from 1988 through 1990 and a follow-up examination 5 years later from 1993 through 1995. At both examinations, participants had refraction and photographic assessment of cataract, according to a standardized protocol. Myopia was defined as a spherical equivalent of -1.0 diopters (D) or less, hyperopia as +1.0 D or more. The relations between refractive errors at baseline and cataract at baseline (prevalent cataract), 5-year incident cataract, and incident cataract surgery were analyzed by using generalized estimating equations.


RESULTS
When age and gender were controlled for, myopia was related to prevalent nuclear cataract (odds ratio [OR], 1.67; 95% confidence interval [CI], 1.23-2.27), but not to cortical and posterior subcapsular cataracts. Myopia was not related to 5-year incident nuclear, cortical, and posterior subcapsular cataracts, but was related to incident cataract surgery (OR 1.89; CI 1.18-3.04). Hyperopia was related to incident nuclear (OR 1.56; CI 1.25-1.95) and possibly cortical (OR 1.25; CI 0.96-1.63) cataracts, but not to posterior subcapsular cataract or cataract surgery. After further adjustment for diabetes, smoking, and education, the association between myopia and incident cataract surgery was attenuated (OR 1.60; CI 0.96-2.64), but the associations between hyperopia and incident nuclear and cortical cataracts were unchanged.


CONCLUSIONS
These data support the cross-sectional association between myopia and nuclear cataract seen in other population-based studies, but provide no evidence of a relationship between myopia and 5-year incident cataract. Hyperopia may be related weakly to incident nuclear and cortical cataract.
Wong
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Department of Ophthalmology and Visual Sciences, University of Wisconsin, Madison 53705-2397, USA. wong@epi.ophth.wisc.edu
Klein
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Klein
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Tomany
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Lee
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D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002386:Cataract / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006956:Hyperopia / Q000453:epidemiology*; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009216:Myopia / Q000453:epidemiology*; D015995:Prevalence; D014922:Wisconsin / Q000453:epidemiology