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In the context of evaluating a patient for cataract surgery, the least important systemic illness is urinary incontinence. While urinary incontinence is relevant to overall patient care and may affect a patient's daily quality of life, it does not directly impact the surgical procedure or the recovery process associated with cataract surgery.

On the other hand, diabetes mellitus is critical to assess as it can affect healing, increase the risk of postoperative complications, and influence the patient's overall eye health, including the risk of diabetic retinopathy. Hypertension is also an important factor because it can complicate anesthesia management and affect surgical outcomes. Asthma can be significant as well since it may have implications for anesthesia and the patient’s respiratory status during surgery.

In summary, while all systemic illnesses should be taken into account during the preoperative assessment, urinary incontinence does not have a direct impact on the surgical risks or outcomes related to cataract procedures, making it the least important among the options provided.