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Incidence and risk factors for posttransplant subcapsular cataract: a long-term retrospective cohort study
K Albert1, J Sennesael, P Haentjens
1Department of Ophthalmology, Universitair Medisch Centrum Sint-Pieter, Brussels, Belgium.
Background:
The occurrence and risk factors for posterior subcapsular cataract (PSC) after renal transplantation have received little attention.
Objectives:
To analyze the cumulative incidence of PSC after renal transplantation and identify risk factors for the development of PSC.
Methods:
Retrospective review of the records of the patients who underwent kidney transplantation between May 1986 and December 2008.
Results:
We included 94 renal transplant recipients who showed PSC incidence at 5, 10, and 15 years of 3.5%, 40.5%, and 50.1%, respectively. Cumulative incidence of PSC during the follow-up was 37.2%. On multivariate analysis, age, body mass index (BMI) and cumulative corticosteroid dose were significantly associated with PSC. Recipient age above 50 years (hazard ratio [HR] = 2.88, 95% confidence interval [CI]: 1.42-5.83; P = .003), BMI above 25 kg/m(2) (HR = 2.28, CI: 1.09-4.78; P = .029), and prednisolone dose above 3 mg/kg/mo (HR = 7.79, CI: 3.34-18.99; P < .001) were independent risk factors for PSC. Diabetes, renal diagnosis, duration, and type of dialysis and posttransplant immunosuppressive regimen did not influence the occurrence of PSC.
Conclusion:
The risk of PSC was low during the first years after transplantation reaching a plateau at 15 years posttransplantation. Among the risk factors for PSC, cumulative corticosteroid dose and body weight were the only modifiable risk factors.
