Impact of Cataract Surgery on Motor Vehicle Crash Involvement by Older Adults

Abstract

Context Motor vehicle crash risk in older drivers is elevated in those with cataract, a condition that impairs vision and is present in half of adults aged 65 years or older. Objective To determine the impact of cataract surgery on the crash risk for older adults in the years following surgery, compared with that of older adults who have cataract but who elect to not have surgery. Design, Setting, and Patients Prospective cohort study of 277 patients with cataract, aged 55 to 84 years at enrollment, who were recruited from 12 eye clinics in Alabama from October 1994 through March 1996, with 4 to 6 years of follow-up (to March 1999). Main Outcome Measure Police-reported motor vehicle crash occurrence involving patients who elected to have surgery compared with those who did not. Results Comparing the cataract surgery group (n=174) with the no surgery group (n=103), the rate ratio for crash involvement was 0.47 (95% confidence interval, 0.23-0.94), adjusting for race and baseline visual acuity and contrast sensitivity. The absolute rate reduction associated with cataract surgery was 4.74 crashes per million miles of travel. Conclusions In our sample, patients with cataract who underwent cataract surgery and intraocular lens implantation had half the rate of crash involvement during the follow-up period compared with cataract patients who did not undergo surgery. Cataract surgery thus may have a previously undocumented benefit for older driver safety, reducing subsequent crash rate.

Vision and Night Driving Abilities of Elderly Drivers

“…Cataracts can seriously decrease VA and contrast sensitivity and increase disability glare (Jefferis et al 2011) and thus lead to a higher risk of being involved in at-fault crashes . Cataract surgery can improve VA and contrast sensitivity and reduce disability glare (Elliott et al 1997;Rubin et al 1993) and thus might also reduce the rate of crash involvement (Owsley et al 2002).…”

Individual difference factors in risky driving among older adults

“…For example, visual deficits that are improved through vision correction or cataract removal have been found to result in reduced crash risk (Owsley et al, 2002). Cognitive training programs, particularly those designed to enhance speed of processing, have demonstrated increased mobility and improved on-the-road driving performance (Ball & Owsley, 2000;Edwards et al, 2002;Roenker, Cissell, Ball, Wadley, & Edwards, 2003).…”

Vision and driving status of older Australians with cataract: an investigation of public hospital waiting lists

“…6 A decrease in crash risk following cataract surgery was demonstrated with four to six years of prospective data, whereby those who elected to have surgery had approximately half the crash rate of those who did not have surgery. 7 Analysis using linked data from Western Australia has found a 13 per cent reduction in crashes in the one year after cataract surgery, compared to the year prior to surgery. 8 Economic analyses simulating crash involvement for drivers aged 60 to 89 years with current routine surgical waiting times compared to earlier surgery, predicted a 21 per cent reduction in societal costs of motor vehicle crashes and fatalities.…”