title: Pseudoexfoliation syndrome and the long-term incidence of cataract and cataract surgery: the blue mountains eye study.
abstract: OBJECTIVE
  To assess whether the pseudoexfoliation syndrome (PXS) is associated with the long-term incidence of cataract or cataract surgery.
  
  
  METHODS
  Population-based cohort study.
  
  
  METHODS
  The Blue Mountains Eye Study examined 3654 persons 49 years of age and older at baseline; 2564 were re-examined after 5 or 10 years, or both. PXS was recorded at the baseline eye examination by an ophthalmologist. Masked graders assessed lens photographs using the Wisconsin Cataract Grading System. Generalized estimating equation regression models were used to examine the association between PXS and cataract by eye.
  
  
  RESULTS
  Eyes with PXS had a significantly greater prevalence of cortical cataract (P=.02) and nuclear cataract (P < .0001) than eyes without PXS. The association between PXS and cortical cataract, however, did not persist after further adjustment for age, gender, smoking, diabetes, steroid use, myopia, socioeconomic status, and open-angle glaucoma (odds ratio [OR], 0.89; 95% confidence interval [CI], 0.53 to 1.46), whereas the association between PXS and nuclear cataract persisted after adjustment for the above confounders (OR, 1.90; 95% CI, 1.04 to 3.48). In addition, significant associations were found between the presence of PXS at baseline and the 10-year incidence of either nuclear cataract (P < .0001) or cataract surgery (P < .0001). These associations persisted after adjustment for the potential confounders listed above (OR, 3.25; 95% CI, 1.38 to 7.65; and OR, 4.09; 95% CI, 2.25 to 7.44; respectively). No significant cross-sectional or longitudinal associations were found between PXS and posterior subcapsular cataract.
  
  
  CONCLUSIONS
  Long-term follow-up data from this population-based older cohort suggest that the presence of PXS is associated with an increased risk of nuclear cataract and cataract surgery.
authors.affiliation: Centre for Vision Research, Department of Ophthalmology and Westmead Millennium Institute, University of Sydney, Sydney, Australia.
authors.forename: Gowri L
authors.initials: GL
authors.lastname: Kanthan
authors.forename: Paul
authors.initials: P
authors.lastname: Mitchell
authors.forename: George
authors.initials: G
authors.lastname: Burlutsky
authors.forename: Elena
authors.initials: E
authors.lastname: Rochtchina
authors.forename: Jie Jin
authors.initials: JJ
authors.lastname: Wang
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002386:Cataract / Q000175:diagnosis / Q000453:epidemiology*; D002387:Cataract Extraction / Q000706:statistics & numerical data*; D015331:Cohort Studies; D017889:Exfoliation Syndrome / Q000150:complications* / Q000175:diagnosis; D005260:Female; D005500:Follow-Up Studies; D005901:Glaucoma / Q000175:diagnosis / Q000209:etiology; D006801:Humans; D015994:Incidence; D007429:Intraocular Pressure; D008297:Male; D008875:Middle Aged; D009517:New South Wales / Q000453:epidemiology; D015995:Prevalence; D011795:Surveys and Questionnaires; D014065:Tonometry, Ocular