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PURPOSE: To identify risk factors for cataracts treated surgically in postmenopausal women. DESIGN: Population-based, prospective cohort study. PARTICIPANTS: A total of 1 312 051 postmenopausal women in the UK Million Women Study, aged 56 years on average (standard deviation [SD], 4.8), without previous cataract surgery, hospital admission with cataracts, or cancer at baseline, were followed for cataracts treated surgically. METHODS: Cox regression was used to calculate adjusted relative risks (RRs) for cataract surgery by lifestyle factors, treatment for diabetes, reproductive history, and use of hormonal therapies. MAIN OUTCOME MEASURES: Cataract surgery identified by linkage to central National Health Service (NHS) records for inpatient and day-patient admissions (Hospital Episode Statistics for England and Scottish Morbidity Records in Scotland). RESULTS: Overall, 89 343 women underwent cataract surgery during an average of 11 (SD, 3) years of follow-up. Women with diabetes were at greatest risk (diabetes vs. no diabetes RR, 2.90; 95% confidence interval [CI], 2.82-2.97). Other factors associated with an increased risk of cataract surgery were current smoking (current smokers of ≥15 cigarettes/day vs. never smokers RR, 1.26; 95% CI, 1.23-1.30) and obesity (body mass index [BMI] ≥30 vs. <25 kg/m(2); RR, 1.12; 95% CI, 1.10-1.14). CONCLUSIONS: Diabetes, smoking, and obesity were risk factors for cataract surgery. Alcohol use, physical activity, reproductive history, and use of hormonal therapies had little, if any, association with cataract surgery risk.

Original publication




Journal article



Publication Date





1704 - 1710


Alcohol Drinking, Cataract, Cataract Extraction, Cohort Studies, Contraceptives, Oral, Hormonal, Diabetes Mellitus, Female, Humans, Incidence, Middle Aged, National Health Programs, Obesity, Postmenopause, Prospective Studies, Reproductive History, Risk Assessment, Risk Factors, Smoking, Surveys and Questionnaires, United Kingdom