Increasing Number of Cataract Extractions in a Hungarian Ophthalmology Clinic Between 1987–1996

Judit Szabó1, Mária Bausz2, Orsolya Ispán2, Ildikó Süveges2, and László D. Szabó1

1 “Frédéric Joliot-Curie” National Research Institute for Radiobiology and Radiohygiene, Budapest, Hungary
2 1st Ophthalmology Department of Semmelweis University of Medicine, Budapest, Hungary
 
Corresponding author: Dr. Judit Szabó
“Frédéric Joliot-Curie” National Research Institute for Radiobiology and Radiohygiene
H-1775 Budapest,
P.O.Box 101, Hungary
Telephone/Fax: +36 1 226 5331

CEJOEM 1998, Vol.4. No.1.:66-81

Key words:
Ultraviolet radiation, cataract extraction, epidemiology, ozone depletion

Abbreviations:
CA – cortical anterior opacity
PCL – posterior chamber lens
N – nuclear opacity
ACL – anterior chamber lens
PSC – posterior subcapsular opacity
ICCE – intracapsular cataract extraction
UV – ultraviolet
IOL – intraocular lens implantation
ECCE – extracapsular cataract extraction 


Abstract:
In the last fifteen years a great improvement in the technique of cataract surgery was made. Intraocular lens (IOL) implantation technique shows advantages compared to simple extracapsular cataract extraction. IOL was introduced in 1984 and from the year 1992 on it was the leading procedure (>80%) in the 1st Ophthalmology Department of Semmelweis University of Medicine, Budapest, Hungary. The number of cataract extractions tripled between 1987–1996. The increase occurred in all age groups between 30–64 years at about the same rate (mean: 1.7x) except for the 45–49 year olds (3.2x). The sharpest rise occurred in very young and very old ages. There were significantly more women, and more men below 60 years. Mean age was 67 years (males 63, females 69). Mode was 72 years (males 72, females 75). The mean age per year decreased by the end of the period.
    The prevalence of cataract may act as a measure of well-being and/or adaptation level of a population between given socio-economical-environmental conditions. The continous rise of the number of cataract extractions beyond a well established surgical procedure reflect increased stress level of the population. The change in the technique of cataract surgery may have not been the only cause of increase of cataract extractions in the given ophthalmology clinic. During the given period in Hungary influence of enhanced social-economical stress (added to given lifestyle and eating habits) occurred together with a steadily increasing global ambient ultraviolet insolation due to the stratospheric ozone loss, and a periodic UV increase of the eleven-year sun cycle origin (maximum sunspot number in 1989). The aethiological role of increased UV-B radiation cannot be judged (shortness of period, patients represent only part of the population). Follow-up in the same clinic would be useful in order to be able to guess long-term trends, for which the base-line data and analysis are now available. For prevalence data the extension of the survey to the whole country would be required, by which we could gain a general morbidity index of the population (not only cataract), and a biological effect index, by which we could measure the effect of future ambient UV radiation in case of increase. 

Received: 3 December, 1997
Accepted: 9 February, 1998 
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Posted: 15 November 1998