Nationwide incidence of congenital and infantile cataract requiring surgery in Korea

Abstract

Congenital and infantile (CI) cataract is one of the most important and preventable cause of blindness in children, but the incidence has not been studied in Korea. We collected data from the national claims database of the National Health Insurance Service of Korea from 2002 through 2019. We identified children who underwent cataract surgery within the age of 5 years, and cumulative incidence rates were calculated for each of the three age criteria. 989 patients out of 4,221,459 births underwent surgery with CI cataract during the period. The cumulative incidence rates per 10,000 births were 1.60 (0-1 years), 2.38 (0-3 years), and 2.95 (0-5 years), respectively. The incidence peaked in the 2007 birth cohort, which coincides with the start of the national screening program for infants/children. Primary intraocular lens implantation was performed in 439 patients (44%). Strabismus and glaucoma requiring surgery occurred in 291 patients (29.4%) and 32 patients (3.2%), respectively, within 8 years after cataract surgery. The incidence rates of CI cataract in Korea appear to be comparable to previous studies in other regions. The early screening program for infants may reduce delayed diagnosis and increase the proportion of patients undergoing surgery at a critical time for visual development.

Figure 1

Cumulative incidence of congenital and infantile cataract by annual birth cohorts. Compared to 2004 and 2006, there was a significant increase in the incidence rates of true congenital and infantile (CI) cataracts and possible CI cataracts in 2007 (P = 0.02 for both true CI cataract and possible CI cataract compared to 2004, P = 0.04 for true CI cataract and P = 0.003 for possible CI cataract compared to 2006) Additionally, the incidence rate of true CI cataracts in 2008 showed a significant difference compared to 2006 (P = 0.04). This outcome might have been influenced by a government-led screening program launched in 2007. Yearly significant differences in incidence rates are displayed at the top of the graph in the format 'P value for true CI cataract difference/P value for possible CI cataract,' with '*' denoting P < 0.05 and '**' denoting P < 0.01.