TY - JOUR
T1 - Post–Cataract Surgery Optic Neuropathy
T2 - Prevalence, Incidence, Temporal Relationship, and Fellow Eye Involvement
AU - Moradi, Ahmadreza
AU - Kanagalingam, Sivashakthi
AU - Diener-West, Marie
AU - Miller, Neil R.
N1 - Publisher Copyright:
© 2016 Elsevier Inc.
PY - 2017/3/1
Y1 - 2017/3/1
N2 - Purpose To reassess the prevalence and incidence of post–cataract surgery optic neuropathy (PCSON) in the modern era. Design Retrospective cohort study. Methods SETTING: Single-center tertiary care practice. STUDY POPULATION: All patients with a diagnosis of nonarteritic anterior ischemic optic neuropathy (NAION) seen in the Wilmer Eye Network system between January 1, 2010 and December 31, 2014 were included. Inclusion was based on the following: (1) a history of an acute unilateral decrease in vision, (2) a visual field defect consistent with NAION, (3) a relative afferent pupillary defect, (4) observed optic disc swelling, and (5) no other etiology being found. MAIN OUTCOME MEASURES: The prevalence and incidence of PCSON and the temporal association between surgery and onset of PCSON. The secondary outcome was the risk of PCSON in the fellow eye of patients with prior unilateral spontaneous NAION. Results One hundred eighty-eight patients had developed NAION during the study period. Of these, 18 (9.6%) had undergone cataract surgery (CS) during the year prior to developing NAION. There was no significant temporal pattern associated with the distribution of NAION cases (P =.28). The incidence of PCSON in patients who had noncomplex CS was 10.9 cases per 100 000 (95% CI, 1.3, 39.4). Conclusions Our data indicate that both the prevalence and incidence of NAION after modern CS are comparable to those of the general population and that there is no significant temporal relationship between modern CS and the subsequent development of NAION in the operated eye. Thus, although this study has inherent biases owing to its retrospective nature, concern regarding an increased risk of PCSON in the fellow eye in patients who have experienced it or spontaneous NAION in 1 eye may be unwarranted.
AB - Purpose To reassess the prevalence and incidence of post–cataract surgery optic neuropathy (PCSON) in the modern era. Design Retrospective cohort study. Methods SETTING: Single-center tertiary care practice. STUDY POPULATION: All patients with a diagnosis of nonarteritic anterior ischemic optic neuropathy (NAION) seen in the Wilmer Eye Network system between January 1, 2010 and December 31, 2014 were included. Inclusion was based on the following: (1) a history of an acute unilateral decrease in vision, (2) a visual field defect consistent with NAION, (3) a relative afferent pupillary defect, (4) observed optic disc swelling, and (5) no other etiology being found. MAIN OUTCOME MEASURES: The prevalence and incidence of PCSON and the temporal association between surgery and onset of PCSON. The secondary outcome was the risk of PCSON in the fellow eye of patients with prior unilateral spontaneous NAION. Results One hundred eighty-eight patients had developed NAION during the study period. Of these, 18 (9.6%) had undergone cataract surgery (CS) during the year prior to developing NAION. There was no significant temporal pattern associated with the distribution of NAION cases (P =.28). The incidence of PCSON in patients who had noncomplex CS was 10.9 cases per 100 000 (95% CI, 1.3, 39.4). Conclusions Our data indicate that both the prevalence and incidence of NAION after modern CS are comparable to those of the general population and that there is no significant temporal relationship between modern CS and the subsequent development of NAION in the operated eye. Thus, although this study has inherent biases owing to its retrospective nature, concern regarding an increased risk of PCSON in the fellow eye in patients who have experienced it or spontaneous NAION in 1 eye may be unwarranted.
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U2 - 10.1016/j.ajo.2016.10.008
DO - 10.1016/j.ajo.2016.10.008
M3 - Article
C2 - 27984025
AN - SCOPUS:85007388485
SN - 0002-9394
VL - 175
SP - 183
EP - 193
JO - American journal of ophthalmology
JF - American journal of ophthalmology
ER -