Atherosclerotic disease in patients undergoing cataract extraction. A nationwide case-control study. The Cataract Patient Outcomes Research Team
D. A. Street, J. C. Javitt, Q. Wang, J. M. Tielsch, J. K. Canner, E. B. Bass and E. P. Steinberg
Worthen Center for Eye Care Research, Department of Ophthalmology, Georgetown University Medical Center, Washington, DC, USA.
OBJECTIVE: To evaluate the association between cataract extraction and
atherosclerosis and its complications. DESIGN: A nationwide case-control
study. SETTING AND PARTICIPANTS: Using a 5% random sample of all Medicare
beneficiaries, we analyzed Medicare claims data on 60803 persons 65 years
of age and older who underwent cataract extraction in 1986 or 1987 and a
control group of 63765 persons matched to the cases for age, race, sex, ZIP
code, and reason for Medicare entitlement. MAIN OUTCOME MEASURE:
Atherosclerosis and atherosclerosis-related disease and procedures were
defined by International Classification of Diseases, Ninth Revision,
Clinical Modification, codes or by Health Care Financing Administration
Common Procedure Classification System (Current Procedural Terminology)
codes. The strength of evidence for atherosclerotic disease was categorized
on the basis of the types of bills in the Medicare claims file. RESULTS:
Odds of atherosclerosis-related morbidity and procedures were higher for
cases than for controls. The association decreased with patient age and was
strongest in beneficiaries aged 65 to 69 years (odds ratio, 1.30; 95%
confidence interval, 1.13-1.48). CONCLUSION: Our findings suggest that
there is a weak association between a visually significant cataract
requiring surgery and atherosclerosis in the younger elderly.
