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Association of cataract surgery with stroke among older adults in the United States

Eye volume 39, pages 1400–1405 (2025)Cite this article

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Abstract

Background/Objectives

Cataract surgery, one of the most frequent conducted surgeries around the world, is associated with cardiovascular diseases. We aim to determine the association of cataract surgery and the risk of stroke.

Methods

Adults aged over 65 years old in the National Health and Aging Trends Study were followed 7 years annually. There were 6700 stroke-free participants included at baseline survey. These participants were divided into two groups based on past history of cataract surgery. Demographics and multiple comorbidities were compared between the two groups. We identified newly developed cases of stroke over a 7-year period and performed survival analysis. Cox regression was further performed to yield adjusted hazard ratios.

Results

Among 6700 elderly participants, 2803 of them had a history of cataract surgery while 3897 of them had not. Over the 7-year follow-up period, the cumulative stroke-free survival rate among the cataract surgery group and the control group were 84.4% versus 88.6% (p < 0.0001, log-rank test). Compared with the control group, elderly with a history of cataract surgery had a higher risk of developing stroke (adjusted HR 1.36, 95% CI 1.03 to 1.79, p = 0.026) after adjusting for multiple covariates. Other significant predictors included age ≥80 years old, having comorbidities with heart disease, lung disease, and dementia. Contrarily, protective factors for further stroke development included higher education and more frequent outdoor activities.

Conclusions

Our findings suggest that patients with a history of cataract surgery had a 1.36-fold increased risk of future stroke development.

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Fig. 1: Kaplan–Meier Curve of Stroke among Cataract Surgery Group and Control Group.

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Data availability

The data that support the findings of this study are openly available in the National Health and Aging Trends Study (NHATS) at https://nhats.org/researcher/data-access/public-use-files, reference number Grant number NIA U01AG032947. NHATS offers registered users three types of files: downloadable NHATS public data files, downloadable NSOC and other sensitive data files, and restricted files. All files require registration with a username and a password. Sensitive and restricted files require an additional application.

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Acknowledgements

This study was funded by Fu Jen Catholic University Hospital (FJCUH Research Grant: PL-201908019-V).

Funding

This study was funded by Fu Jen Catholic University Hospital (FJCUH Research Grant: PL-201908019-V).

Author information

Authors and Affiliations

  1. Department of Ophthalmology, Chang Gung Memorial Hospital, Keelung, Taiwan

    Tsung-Hsien Tsai

  2. Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan

    Yuan-Ting Chang

  3. School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City, 24205, Taiwan

    Yu-Chen Cheng

  4. Department of Neurology, Fu Jen Catholic University Hospital, Fu Jen Catholic University, New Taipei City, 24352, Taiwan

    Yu-Chen Cheng

Authors
  1. Tsung-Hsien Tsai
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  2. Yuan-Ting Chang
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Contributions

Yu-Chen Cheng contributed to the conception and design of the study, and searched the literature; Tsung-Hsien Tsai had retrieved the data, and conducted the data analysis. Yu-Chen Cheng and Tsung-Hsien Tsai contributed to drafting the manuscript. Yuan-Ting Chang contributed to the figure formation. All authors critically reassessed the study and revised the final version of the manuscript. This manuscript was edited by NOVA Journal Experts.

Corresponding author

Correspondence to Yu-Chen Cheng.

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The Institutional Review Board of Fu Jen Catholic University deemed this study exempt because it consisted of secondary analyses of publicly available data.

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Tsai, TH., Chang, YT. & Cheng, YC. Association of cataract surgery with stroke among older adults in the United States. Eye 39, 1400–1405 (2025). https://doi.org/10.1038/s41433-025-03662-z

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