The Impact of Cataract Surgery on Cognitive Impairment and Depressive Mental Status in Elderly Patients

Ishii, Kotaro; Kabata, Takamichi; Oshika, Tetsuro

doi:10.1016/j.ajo.2008.05.014

Cited by 157 publications

(170 citation statements)

References 19 publications

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“…76 Cataract surgery, which can, at a stroke, eliminate VI for some people, significantly improved vision-related quality of life in elderly patients, and cognitive impairment and depressive mental status also improved in parallel with improvement in vision-related quality of life. 152 The importance of considering each individual and their needs in terms of quality of life was commonly raised in focus groups. Although the benefits of improving VA are undeniable, there was an expressed need to weigh this against the potential risks of distress caused by an eye examination, trying to force people to wear spectacles if they do not want to, or having cataract surgery.…”

Section: Visual Impairment and Behavioural And Functional Abilitymentioning

confidence: 99%

The Prevalence of Visual Impairment in People with Dementia (the PrOVIDe study): a cross-sectional study of people aged 60–89 years with dementia and qualitative exploration of individual, carer and professional perspectives

Bowen

Edgar

Hancock

et al. 2016

Health Serv Deliv Res

121

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BackgroundThe prevalence of visual impairment (VI) and dementia increases with age and these conditions may coexist, but few UK data exist on VI among people with dementia.ObjectivesTo measure the prevalence of eye conditions causing VI in people with dementia and to identify/describe reasons for underdetection or inappropriate management.DesignStage 1 – cross-sectional prevalence study. Stage 2 – qualitative research exploring participant, carer and professional perspectives of eye care.SettingStage 1 – 20 NHS sites in six English regions. Stage 2 – six English regions.ParticipantsStage 1 – 708 participants with dementia (aged 60–89 years): 389 lived in the community (group 1) and 319 lived in care homes (group 2). Stage 2 – 119 participants.InterventionsStage 1 gathered eye examination data following domiciliary sight tests complying with General Ophthalmic Services requirements and professional guidelines. Cognitive impairment was assessed using the Standardised Mini-Mental State Examination (sMMSE) test, and functional ability and behaviour were assessed using the Bristol Activities of Daily Living Scale and Cambridge Behavioural Inventory – Revised. Stage 2 involved individual interviews (36 people with dementia and 11 care workers); and separate focus groups (34 optometrists; 38 family and professional carers).Main outcome measures.VI defined by visual acuity (VA) worse than 6/12 or worse than 6/18 measured before and after refraction.ResultsStage 1 – when participants wore their current spectacles, VI prevalence was 32.5% [95% confidence interval (CI) 28.7% to 36.5%] and 16.3% (95% CI 13.5% to 19.6%) for commonly used criteria for VI of VA worse than 6/12 and 6/18, respectively. Of those with VI, 44% (VA < 6/12) and 47% (VA < 6/18) were correctable with new spectacles. Almost 50% of remaining uncorrectable VI (VA < 6/12) was associated with cataract, and was, therefore, potentially remediable, and one-third was associated with macular degeneration. Uncorrected/undercorrected VI prevalence (VA < 6/12) was significantly higher in participants in care homes (odds ratio 2.19, 95% CI 1.30 to 3.73;p < 0.01) when adjusted for age, sex and sMMSE score. VA could not be measured in 2.6% of group 1 and 34.2% of group 2 participants (p < 0.01). The main eye examination elements (excluding visual fields) could be performed in > 80% of participants. There was no evidence that the management of VI in people with dementia differed from that in older people in general. Exploratory analysis suggested significant deficits in some vision-related aspects of function and behaviour in participants with VI. Stage 2 key messages – carers and care workers underestimated how much can be achieved in an eye examination. People with dementia and carers were unaware of domiciliary sight test availability. Improved communication is needed between optometrists and carers; optometrists should be informed of the person’s dementia. Tailoring eye examinations to individual needs includes allowing extra time. Optometrists wanted training and guidance about dementia. Correcting VI may improve the quality of life of people with dementia but should be weighed against the risks and burdens of undergoing examinations and cataract surgery on an individual basis.LimitationsSampling bias is possible owing to quota-sampling and response bias.ConclusionsThe prevalence of VI is disproportionately higher in people with dementia living in care homes. Almost 50% of presenting VI is correctable with spectacles, and more with cataract surgery. Areas for future research are the development of an eye-care pathway for people with dementia; assessment of the benefits of early cataract surgery; and research into the feasibility of specialist optometrists for older people.FundingThe National Institute for Health Research Health Services and Delivery Research programme.

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Section: Visual Impairment and Behavioural And Functional Abilitymentioning

confidence: 99%

The Prevalence of Visual Impairment in People with Dementia (the PrOVIDe study): a cross-sectional study of people aged 60–89 years with dementia and qualitative exploration of individual, carer and professional perspectives

Bowen

Edgar

Hancock

et al. 2016

Health Serv Deliv Res

121

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“…[1][2][3] Previously, we reported enhanced gait speed and sleep quality after cataract surgery with implantation of yellow-colored, blue light-blocking intra-ocular lens (IOL). 4 The clear, ultraviolet (UV)-blocking and the yellow-colored IOLs currently available show similar properties in terms of visual function with the exception of vision in mesopic or scotopic light conditions.…”

Section: Introductionmentioning

confidence: 99%

Rejuvenation Effects of Cataract Surgery with Ultraviolet Blocking Intra-Ocular Lens on Circadian Rhythm and Gait Speed

Ayaki

Negishi

Tsubota

2014

Rejuvenation Research

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Background: Previously, we reported improvements in sleep quality and gait speed after implantation of a yellow-colored, blue light-blocking intra-ocular lens (IOL). This study evaluated systemic health parameters for 7 months after cataract surgery with implantation of a clear, ultraviolet (UV)-blocking IOL. Methods: A total of consecutive 71 patients (average age 74.1 years) underwent cataract surgery with the implantation of a clear, UV-blocking IOL. Participants were evaluated using the Pittsburgh Sleep Quality Index (PSQI) and the National Eye Institute Visual Function Questionnaire (VFQ-25) before and at 2 and 7 months after surgery. Four-meter gait speed was also determined. The metabolic parameters of serum glycated hemoglobin (HbA1c), triglycerides (TGs), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) were tested. Results: The pre-operative and post-operative (2 and 7 months after surgery) results were 66.4 -16.5, 79.5 -12.6, and 81.0 -13.0 for VFQ-25 score, 5.7 -3.5, 5.1 -3.1, and 4.8 -2.9 for PSQI, and 0.90 -0.22, 0.91 -0.22, and 0.92 -0.22 meters/sec for gait speed. Significant improvements following surgery were noted in the VFQ-25 score for all cases and in the PSQI for poor sleepers (preoperative PSQI > 5.5) (P < 0.05, paired t-test). The gait speed and metabolic parameters showed no significant changes. Conclusions: Cataract surgery with implantation of an UV-blocking clear IOL has the potential for improving circadian rhythm and systemic health parameters.

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“…Surgical peripheral iridectomy was performed in aphakic eyes according to standard protocol. All patients were treated postoperatively with fixed drug combination of Moxifloxacin 0.05% and Difluprednate0.05% ( Ishii K et al, 2008;Kamalrajah S et al, 2004), 4 times a day for 6 weeks. Patients were reviewed on day 1, 5 and every 2 weeks up to 6 weeks.…”

Section: Methodsmentioning

confidence: 99%

“…Studies have shown that elderly patients subjected to cataract surgery will have improved visionrelated quality of life and their mental health will have a positive impact. They also will be benefitted by improvements in cognitive function (Chandrasekaran S et al, 2008;Ishii K et al, 2008) Cataract is any opacification in lens or its capsule, which accounts for about 50% of treatable blindness worldwide. The prevalence of cataract in India is about 62.6%.(Govt.…”

Section: Introductionmentioning

confidence: 99%

Safety of Fixed drug Combination in Post –Operative Cataract Patients, at Tertiary Care Centre – In South India

Ananthaneni

Rashmi

et al. 2017

Nep J Oph

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Introduction: Cataract is any opacification in lens or its capsule, which accounts for about 50% of treatable blindness worldwide. The prevalence of cataract in India is about 62.6%. The incidence of post operative endophthalmitis ranges from 0.05% -0.14% and so the use of post-operative antibiotics and steroids is necessary to control infection and prevent inflammation. Fixed drug combinations not only cut the cost but also the dosage & improve the compliance of patients in the immediate post operative period. In this regard, the present study was conducted with the aim of studying the efficacy of using fixed drug combination (Difluprednate and Moxifloxacin) in reducing ocular inflammation & pain in post-operative patients undergoing cataract surgery. Methodology: Study design: Prospective interventional study, in which 749 eyes underwent SICS with IOL. All of them were treated with Difluprednate and Moxifloxacin, combination eye drops postoperatively 4 times a day, and reviewed on day 1, 5 and once in two weeks up to 6 weeks. Results: Out of 749 eyes, 730 were normal, 10 eyes had minimal raise in IOP in the range of 21 mmHg-31mmHg (considering 21mmHg as baseline) which decreased without any intervention within 3 weeks and only 9 eyes had raise in IOP of more than 31mmHg, which did not decrease in spite of discontinuing the drops and needed anti-glaucoma treatment. Conclusion: Our study clearly shows that fixed drug combination of antibiotic and steroid does not cause raised IOP in about 97% of cases of SICS in the post-operative period and also improves the compliance of the patients.

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The Impact of Cataract Surgery on Cognitive Impairment and Depressive Mental Status in Elderly Patients

Cited by 157 publications

References 19 publications

The Prevalence of Visual Impairment in People with Dementia (the PrOVIDe study): a cross-sectional study of people aged 60–89 years with dementia and qualitative exploration of individual, carer and professional perspectives

The Prevalence of Visual Impairment in People with Dementia (the PrOVIDe study): a cross-sectional study of people aged 60–89 years with dementia and qualitative exploration of individual, carer and professional perspectives

Rejuvenation Effects of Cataract Surgery with Ultraviolet Blocking Intra-Ocular Lens on Circadian Rhythm and Gait Speed

Safety of Fixed drug Combination in Post –Operative Cataract Patients, at Tertiary Care Centre – In South India

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