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Risk of non-arteritic anterior ischaemic optic neuropathy (NAION) after cataract extraction in the fellow eye of patients with prior unilateral NAION
  1. Byron L Lam1,
  2. Haneen Jabaly-Habib1,
  3. Nabih Al-Sheikh1,
  4. Matthew Pezda1,
  5. Medhat F Guirgis1,
  6. William J Feuer1,
  7. Timothy J McCulley2
  1. 1University of Miami Miller School of Medicine, Bascom Palmer Eye Institute, Miami, Florida, USA
  2. 2Department of Ophthalmology, School of Medicine, University of California San Francisco, San Francisco, California, USA
  1. Correspondence to: Dr B L Lam Bascom Palmer Eye Institute, 900 NW 17th Street, Miami, FL 33136, USA; blam{at}med.miami.edu

Abstract

Aim: To determine the risk of non-arteritic anterior ischaemic optic neuropathy (NAION) after cataract extraction (CE) in the fellow eye of patients with prior unilateral NAION.

Design: Retrospective, cohort study.

Methods: Medical records of patients with NAION evaluated in our institution between 1 January 1986 and 31 December 2001 were reviewed to determine the onset of NAION and the time of CE. Patients were excluded if the date of NAION and CE was unreliable, or if CE in the fellow eye was performed before the unilateral NAION. Statistical analysis was performed by including fellow eye CE as a time-dependent covariate in a Cox proportional hazards regression model of NAION incidence in the fellow eye.

Results: Of the 325 eligible patients, 9 (53%) of 17 patients with NAION who underwent CE in the fellow eye developed fellow eye NAION, and 59 (19%) of 308 patients with NAION who did not undergo CE in the fellow eye developed fellow eye NAION. Cataract extraction in the fellow eye increased the risk of NAION occurrence in the fellow eye by 3.6-fold (Cox regression, p = 0.001).

Conclusions: Patients with unilateral NAION are at a significantly higher risk of developing NAION in the fellow eye after CE.

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Footnotes

  • Published Online First 10 January 2007

  • Funding: This work was supported by National Institute of Health grant P30-EY014801 and by an unrestricted grant to the University of Miami from Research to Prevent Blindness.

  • Competing interests: None.

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