Risk of Nonarteritic Anterior Ischemic Optic Neuropathy After Cataract Surgery.

PURPOSE: To determine whether the development of nonarteritic anterior ischemic optic neuropathy (NAION) is increased after receiving cataract surgery in a large general population.

DESIGN

Nationwide, population-based, retrospective cohort study.

METHODS

Setting

A 12-year nationwide, population-based, retrospective cohort study including 1,025,340 beneficiaries in the 2002-2013 Korean National Health Insurance Service database.

PATIENTS: We identified 40,356 patients who had undergone cataract surgery and matched non-cataract surgery controls (1:2) using estimated propensity scores in reference to age, sex, demographics, comorbidities, and co-medications.

OBSERVATIONS: Kaplan-Meier curves and Cox proportional hazard models were generated to determine the risk of developing NAION in the cataract surgery group compared to the non-cataract surgery group.

MAIN OUTCOME MEASURES: Effect (hazard ratio [HR]) of cataract surgery on NAION development.

RESULTS

The 10-year incidence probability of NAION was 0.70% (95% confidence interval [CI], 0.55%-0.86%) in the cataract surgery group and 0.27% (95% CI, 0.25%-0.29%) in the non-cataract surgery group (P < .0001, log-rank test). The cataract surgery group had an increased risk of developing NAION compared to the non-cataract surgery group (HR = 1.80; 95% CIs, 1.46-2.21) even after adjusting for demographics, comorbidities, Charlson comorbidity index, and co-medications.

CONCLUSION

Our results suggest that patients undergoing cataract surgery have an increased risk of NAION.