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Self-reported cataract surgery and 10-year all-cause and cause-specific mortality: findings from the National Health and Nutrition Examination Survey
  1. Yifan Chen1,2,
  2. Wei Wang3,
  3. Huan Liao4,
  4. Danli Shi3,
  5. Zachary Tan5,
  6. Xianwen Shang1,
  7. Xueli Zhang1,
  8. Yu Huang1,
  9. Qingrong Deng6,
  10. Honghua Yu1,
  11. Xiaohong Yang1,
  12. Mingguang He1,3,5,
  13. Zhuoting Zhu1
  1. 1 Guangdong Eye Institute, Department of Ophthalmology, Guangdong Academy of Medical Sciences, Guangdong Provincial People's Hospital, Guangzhou, Guangdong, China
  2. 2 John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
  3. 3 State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, Guangdong, China
  4. 4 Neural Regeneration Group, Institute of Reconstructive Neurobiology, University of Bonn, Bonn, Germany
  5. 5 Centre for Eye Research Australia, Royal Victorian Eye & Ear Hospital, East Melbourne, Victoria, Australia
  6. 6 Sun Yat-Sen University, Guangzhou, China
  1. Correspondence to Dr Mingguang He, Sun Yat-Sen University Zhongshan Ophthalmic Center State Key Laboratory of Ophthalmology, Guangzhou, China; mingguang_he{at}; Dr Honghua Yu; yuhonghua{at}; Dr Xiaohong Yang; syyangxh{at}; Dr Zhuoting Zhu; zhuoting_zhu{at}


Purpose To investigate the association of self-reported cataract surgery with all-cause and cause-specific mortality using a large-scale population-based sample.

Methods Data from the 1999–2008 cycles of the National Health and Nutrition Examination Survey were used. A self-reported history of cataract surgery was considered a surrogate for the presence of clinically significant cataract surgery. Mortality data were ascertained from National Death Index records. Hazard ratios (HRs) and 95% confidence intervals (CIs) for survival were estimated using Cox proportional hazards regression models.

Results A total of 14 918 participants were included in the analysis. During a median follow-up of 10.8 (Interquartile range, IQR, 8.25–13.7) years, 3966 (19.1%) participants died. Participants with self-reported cataract surgery were more likely to die from all causes and specific causes (vascular disease, cancer, accident, Alzheimer’s disease, respiratory disease, renal disease and others) compared with those without (all Ps <0.05). The association between self-reported cataract surgery and all-cause mortality remained significant after multiple adjustments (HR=1.13; 95% CI 1.01 to 1.26). For cause-specific mortality, multivariable Cox models showed that self-reported cataract surgery predicted a 36% higher risk of vascular-related mortality (HR=1.36; 95% CI 1.01 to 1.82). The association with other specific causes of mortality did not reach statistical significance after multiple adjustments.

Conclusions This study found significant associations of self-reported cataract surgery with all-cause and vascular mortalities. Our findings provide potential insights into the pathogenic pathways underlying cataract.

  • epidemiology

Data availability statement

Data are available upon reasonable request.

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Data availability statement

Data are available upon reasonable request.

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  • Correction notice This article has been corrected since it was first published. In table 1, the headers ‘Non-surgery group’ and ‘Cataract surgery group’ were transposed.

  • Contributors Study concept and design: YC, WW, ZT, XY, MH. Acquisition, analysis or interpretation: WW, XS, ZZ. Drafting of the manuscript: YC, W, HL, ZZ. Critical revision of the manuscript for important intellectual content: DS, ZT, XZ, YH, QD, HY, MH. Statistical analysis: WW, XS, ZZ.Obtained funding: XY, MH. Administrative, technical or material support: XY, MH. Study supervision: XY, MH.

  • Funding The present work was supported by the Fundamental Research Funds of the State Key Laboratory of Ophthalmology, Project of Investigation on Health Status of Employees in Financial Industry in Guangzhou, China (Z012014075), Science and Technology Program of Guangzhou, China (202002020049). ZZ receives the support from the National Natural Science Foundation of China (82101173) and the Research Foundation of Medical Science and Technology of Guangdong Province (B2021237). MH receives support from the University of Melbourne at Research Accelerator Programme and the CERA Foundation.

  • Disclaimer The Centre for Eye Research Australia receives Operational Infrastructure Support from the Victorian State Government. The sponsor or funding organisation had no role in the design or conduct of this research.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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