title: Post-Cataract Surgery Optic Neuropathy: Prevalence, Incidence, Temporal Relationship, and Fellow Eye Involvement.
abstract: OBJECTIVE
  To reassess the prevalence and incidence of post-cataract surgery optic neuropathy (PCSON) in the modern era.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  Setting: Single-center tertiary care practice.
  
  
  METHODS
  All patients with a diagnosis of nonarteritic anterior ischemic optic neuropathy (NAION) seen in the Wilmer Eye Network system between January 1, 2010 and December 31, 2014 were included. Inclusion was based on the following: (1) a history of an acute unilateral decrease in vision, (2) a visual field defect consistent with NAION, (3) a relative afferent pupillary defect, (4) observed optic disc swelling, and (5) no other etiology being found.
  
  
  METHODS
  The prevalence and incidence of PCSON and the temporal association between surgery and onset of PCSON. The secondary outcome was the risk of PCSON in the fellow eye of patients with prior unilateral spontaneous NAION.
  
  
  RESULTS
  One hundred eighty-eight patients had developed NAION during the study period. Of these, 18 (9.6%) had undergone cataract surgery (CS) during the year prior to developing NAION. There was no significant temporal pattern associated with the distribution of NAION cases (P = .28). The incidence of PCSON in patients who had noncomplex CS was 10.9 cases per 100 000 (95% CI, 1.3, 39.4).
  
  
  CONCLUSIONS
  Our data indicate that both the prevalence and incidence of NAION after modern CS are comparable to those of the general population and that there is no significant temporal relationship between modern CS and the subsequent development of NAION in the operated eye. Thus, although this study has inherent biases owing to its retrospective nature, concern regarding an increased risk of PCSON in the fellow eye in patients who have experienced it or spontaneous NAION in 1 eye may be unwarranted.
authors.affiliation: Department of Ophthalmology, The Wilmer Eye Institute, The Johns Hopkins University School of Medicine, Baltimore, Maryland.
authors.forename: Ahmadreza
authors.initials: A
authors.lastname: Moradi
authors.affiliation: Department of Ophthalmology, The Wilmer Eye Institute, The Johns Hopkins University School of Medicine, Baltimore, Maryland.
authors.forename: Sivashakthi
authors.initials: S
authors.lastname: Kanagalingam
authors.affiliation: Department of Ophthalmology, The Wilmer Eye Institute, The Johns Hopkins University School of Medicine, Baltimore, Maryland; Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
authors.forename: Marie
authors.initials: M
authors.lastname: Diener-West
authors.affiliation: Department of Ophthalmology, The Wilmer Eye Institute, The Johns Hopkins University School of Medicine, Baltimore, Maryland. Electronic address: nrmiller@jhmi.edu.
authors.forename: Neil R
authors.initials: NR
authors.lastname: Miller
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002387:Cataract Extraction / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008396:Maryland / Q000453:epidemiology; D008875:Middle Aged; D018917:Optic Neuropathy, Ischemic / Q000453:epidemiology* / Q000209:etiology; D011183:Postoperative Complications; D015995:Prevalence; D012189:Retrospective Studies; D013997:Time Factors; D055815:Young Adult