The impact of first and second eye cataract surgeries on falls: a prospective cohort study

Abstract

PurposeThe purpose of this study was to investigate the impact of the first and second eye cataract surgeries on the risk of falls in participants with bilateral cataract and to determine which changes in visual measures are associated with changes in the number of falls throughout the cataract surgery process.Patients and methodsFifty-five older adults with bilateral cataract aged 55+ years were assessed at three time points during the cataract surgery process, and they completed a falls diary. Two separate generalized estimating equation–negative binomial models were undertaken to assess changes in the number of falls before first eye cataract surgery, between first and second eye surgeries, and after second eye cataract surgery and which changes in visual measures were associated with changes in the number of falls.ResultsAfter adjusting for potential confounding factors, the risk of falls decreased by 54% (incidence rate ratio (IRR) =0.458, 95% CI=0.215–0.974, p=0.04) after first eye cataract surgery only, compared with the period before first eye surgery. The risk of falls decreased by 73% (IRR =0.268, 95% CI =0.114–0.628, p=0.002) after second eye cataract surgery, compared with the period before first eye surgery. Improved binocular visual acuity (IRR =5.488, 95% CI =1.191–25.282, p=0.029) and contrast sensitivity (IRR =0.257, 95% CI =0.070–0.939, p=0.040) were associated with a decrease in the number of falls.ConclusionThe study found that first and second eye cataract surgeries reduced the risk of falls among a cohort of bilateral cataract patients with relatively good baseline vision. This suggests that timely first and second eye cataract surgeries could play an important role in reducing the burden due to falls among older adults with cataract.

Impact of blindness due to cataract in elderly fallers: findings from a cross-sectional study in Andhra Pradesh, South India

“…A study conducted previously in hospitalized patients revealed a significant association between visual impairments and falls (adjusted odds ratio: 13.9%; p < 0.001) which is in accordance with our study findings [ 22 ]. Our study findings demonstrate the importance of cataract surgical intervention in elderly patients in order to prevent the falls due to decreased visual acuity which support the evidence published most recently by Stephen Lord and others [ 10 , 11 , 23 , 24 ]. Reduced ability to detect low contrast hazards, judge distances and perceive spatial relationships by patients are the major visual impairment associated with increased risk of falls [ 11 ].…”

Falls and visual impairment among elderly residents in ‘homes for the aged’ in India

“…Addressing modifiable risk factors such as VI can help in reducing falls in the elderly. Cataract surgery in one or both eyes is known to prevent falls in elderly 41 - 43 . However, some studies have shown that cataract surgery is not associated with a reduction in falls in the elderly 44 , 45 .…”

Impact of first and second eye cataract surgery on physical activity: a prospective study

“…For the CEDAR Study, a total of 111 participants were recruited consecutively from three public hospitals in Western Australia (WA) and completed the first assessment. Previous papers have been published from this study based on the naturalistic driving data collected17–19; a falls diary component20 and further examinations of driving simulator performance are also planned. The current analysis of physical activity outcomes includes only 55 participants who completed the first, second and third assessments.…”

“…The current analysis of physical activity outcomes includes only 55 participants who completed the first, second and third assessments. This is the same subset of participants included in the study of fall outcomes20 but these results are based on data collected from a detailed questionnaire administered as part of the study.…”