ArticleFrontiers in medicine2026
Characteristics of cataracts in dry-hot valley-type high-altitude surgical cohort: a retrospective descriptive case series of 556 eyes from western China.
Article in Frontiers in medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: To describe the morphological characteristics and severity distribution of age-related cataracts in a surgical cohort from a dry-hot valley-type high-altitude region, and to explore age- and gender-related patterns. Methods: This retrospective descriptive case series included 330 consecutive patients (556 eyes) who met cataract surgical criteria at the People's Hospital of Derong from October 1, 2023, to June 20, 2025. Cortical, nuclear, and posterior subcapsular opacities were graded using the Lens Opacities Classification System III (LOCS III). Univariable comparisons (chi-square, Mann-Whitney U) and multivariable logistic regression with cluster-robust standard errors were performed to identify factors associated with severe opacities. A sensitivity analysis using one randomly selected eye per patient was conducted. No individual UV exposure data were collected. Results: Cortical opacity had the highest mean grade (3.18), followed by posterior subcapsular opacity (2.64) and nuclear (2.59). Severe opacities (C4-5, N4-5, P3-4) accounted for 35.3%, 16.7%, and 60.4% of all examined eyes, respectively. Among eyes from patients aged ≤60 years, who made up 17.3% of the total sample, 63.5% had severe posterior subcapsular opacity, and 27.1% of this younger subgroup had mature cataracts (C5 or P4 with absent fundus red reflex). Age was significantly correlated with all three opacity types (Kendall's tau-b: cortical 0.336, Conclusion: In this surgically treated cohort from a dry-hot valley region, cataracts presented with a disproportionately high prevalence of severe opacities, particularly posterior subcapsular cataract, with evidence of early onset. The findings are hypothesis-generating and suggest that environmental factors, including intense UV exposure, may contribute. However, individual-level exposure data are required to confirm causality. These results support the adoption of age-stratified cataract screening strategies and UV protection measures in ecologically vulnerable regions with similar environmental characteristics.
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