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BACKGROUND: An advanced age and the female sex are widely recognized risk factors for both cataract and dementia. We investigated the effect of cataract surgery on the incidence of dementia in a Korean population aged ≥ 45 years with a previous diagnosis of cataract. METHODS: This nationwide cohort study was performed using Korean National Health Insurance Service data collected from 2006 to 2017. A total of 300,327 subjects aged ≥ 45 years with a history of cataract diagnosis but no previous diagnosis of dementia were analyzed. The relationship between cataract surgery and dementia was evaluated, applying a time-varying analysis to evaluate the hazard ratio (HR) and 95% confidence interval (CI) values according to dementia. It was calculated via a multivariable Cox regression model, with adjustments for age, sex, visual acuity (VA), ocular and systemic comorbidities, and social factors (including body mass index, income, smoking, and drinking). RESULTS: In the multivariate analysis, the cataract surgery group showed a marginal difference in dementia development (HR 1.10 [95% CI 1.02-1.19]) because both cataract and dementia share common risk factors. However, in the subgroup analysis, men (HR 0.49 [95% CI 0.26-0.90]) and patients under 65 years of age (HR 0.88 [95% CI 0.79-0.99]) in the group with cataract surgery and good VA showed a significantly lower incidence of dementia. CONCLUSION: Through visual improvement, together with timely surgical intervention, the procedure can alleviate the risk of dementia in visually impaired patients, especially in younger and male patients.
RESUMO
AIM: To assess visual quality after presbyopia correction using an aspheric ablation profile and a micro-monovision protocol. METHODS: This is a retrospective interventional study. Fifty-four eyes of 27 patients (mean age, 50.2±7.5y) who underwent presbyopia correction with an aspheric micro-monovision protocol were enrolled. The values of modulation transfer function (MTF) cutoff frequency, Strehl ratio, objective scattering index (OSI) and accommodation range were quantitatively assessed using the HD analyzer. Preoperative and postoperative contrast sensitivity (CS) at far (2.5 m) and near (40 cm) distance and higher-order aberrations (HOAs) were analyzed. Subjective visual satisfaction was evaluated by self-reported questionnaire regarding optical visual symptoms. RESULTS: One year after presbyopia correction, no significant differences were found in the MTF cutoff frequency, Strehl ratio and OSI, however, the HD analyzer accommodation range significantly differed postoperatively (P=0.004). Postoperative CS at 12 and 18 cpd at near showed statistically significant improvement (P=0.020 and 0.008, respectively). Visual performance by self-reported questionnaire revealed satisfactory results in terms of subjective visual quality improvement. CONCLUSION: Objective optical quality parameters show good visual outcomes. Subjective visual quality assessed by self-reported questionnaire in the presbyopia correction group show satisfactory results.
