Evaluation of Systemic Medications Associated With Surgically Treated Cataract Among US Adults

center dot PURPOSE: To comprehensively determine the associa-tions between systemic medications and surgically treated cataract in the US population. center dot DESIGNS: Retrospective cross-sectional study. center dot METHODS: Participants aged >40 years from the 1999-2008 National Health and Nutrition Examination Survey (NHANES) were included. Surgically treated cataract was defined as cataract requiring a procedure. Data on prescription drug use over the past 30 days were collected via home interviews. Drug categories for oph-thalmic indications and those prescribed in less than 0.5% of the participants were excluded from the analysis. Sepa-rate logistic regression models were used to explore asso-ciations between each drug category and surgically treated cataract. The Benjamin-Hochberg procedure was used to control the false discovery rate. center dot RESULTS: A total of 14,931 were included in the present analysis. The weighted prevalence of surgically treated cataract was 9.6% (n= 2010). We identified 20 drug categories that had significant associations with surgically treated cataract, of which 8 associations re-mained statistically significant after further adjustment for pertinent comorbidities. The 3 drug categories with the highest odds ratio (OR) values were tricyclic antide-pressants (OR, 2.21; 95% CI, 1.38-3.51; P = .001), insulin (OR, 2.13; 95% CI, 1.48-3.07; P = 9.41 x10-5) and group III antiarrhythmic agents (OR, 2.00; 95% CI, 1.25-3.19; P = .004). The use of sex hormone combinations among women reduced the risk of having surgically treated cataract (OR, 0.011; 95% CI, 0.001-0.089; P = 5.98 x10-5). Dose-response relationships were observed for all 8 drug categories. center dot CONCLUSIONS: Our comprehensive evaluation pro-vides new knowledge on the complex relationshipsbetween systemic medications and surgically treated cataract. (Am J Ophthalmol 2023;249: 126-136. (c) 2023 The Author(s). Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license ( http://creativecommons.org/licenses/by-nc-nd/4.0/ ))