Purpose: To document the clinical features of discrete nuclear sclerosis in young patients. Setting: Chang-Gung Memorial Hospital, Taoyuan, Taiwan, Republic of China. Methods: The medical records of all patients younger than 45 years with nuclear sclerosis who had cataract surgery at 1 hospital were retrospectively reviewed. Patients with congenital cataract, ocular trauma, ocular disease in addition to myopia, and systemic disease associated with cataract were excluded. The patients' age, sex, bilateral lens status, axial length, original and preoperative refractive status, and preoperative and postoperative best corrected visual acuities (BCVAs) were recorded. Results: Fifty-five eyes of 35 patients aged 32 to 45 years met the study criteria. Nuclear sclerotic cataract was bilateral in 20 patients. The mean age at surgery was 40.64 years ± 3.63 (SD). The mean refraction before the development of cataract was -7.80 ± 3.57 diopters (D) and the mean preoperative refraction, -17.40 ± 6.05 D. The mean axial length was 28.09 ± 2.31 mm. The postoperative BCVA was 20/22 or better in 53 eyes (96.4%). Conclusions: In patients younger than 45 years with cataract in Taiwan, nuclear sclerosis was not a rare cause of visual loss and axial myopia was strongly associated with the formation of nuclear sclerosis. Bilateral sclerosis was observed in most cases. Patients with an axial length greater than 27.0 mm had the greatest risk. Surgical treatment was therapeutic.
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