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Rosenblatt TR, Vail D, Ludwig CA, Al-Moujahed A, Pasricha MV, Ji MH, Callaway NF, Moshfeghi DM. Fall risk in patients with pseudophakic monovision. CANADIAN JOURNAL OF OPHTHALMOLOGY 2023; 58:11-17. [PMID: 34419423 DOI: 10.1016/j.jcjo.2021.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 07/12/2021] [Accepted: 07/24/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Vision changes can precipitate falls in the elderly resulting in significant morbidity and mortality. We hypothesized that pseudophakic monovision and ensuing anisometropia and aniseikonia impact elderly fall risk. This study assessed fall risk in patients with pseudophakic monovision, pseudophakic single vision distance (classic cataract surgery), and cataracts with no surgery. DESIGN Retrospective single-institution cohort study PARTICIPANTS: Patients with bilateral cataracts diagnosed at 60 years of age or older who underwent bilateral cataract surgery (monovision or single vision distance) or did not undergo any cataract surgery (n = 13 385). Patients with unilateral surgery or a fall prior to cataract diagnosis were excluded. METHODS Data were obtained from the Stanford Research Repository. Time-to-fall analysis was performed across all 3 groups. Primary outcome was hazard ratio (HR) for fall after second eye cataract surgery or after bilateral cataract diagnosis. RESULTS Of 13 385 patients (241 pseudophakic monovision, 2809 pseudophakic single vision, 10 335 no surgery), 850 fell after cataract diagnosis. Pseudophakic monovision was not associated with fall risk after controlling for age, sex, and myopia. Pseudophakic single-vision patients had a decreased time to fall compared with no-surgery patients (log rank, p < 0.001). Older age at cataract diagnosis (HR =1.05, 95% confidence interval [CI] 1.04-1.06, p < 0.001) or at time of surgery (HR = 1.05, 95% CI 1.03-1.07, p < 0.001) increased fall risk, as did female sex (HR = 1.29, 95% CI 1.10-1.51, p = 0.002) and preexisting myopia (HR = 1.31, 95% CI 1.01-1.71, p = 0.046) among nonsurgical patients. CONCLUSIONS Pseudophakic monovision did not impact fall risk, but pseudophakic single vision may increase falls compared with patients without cataract surgery.
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Affiliation(s)
- Tatiana R Rosenblatt
- Department of Ophthalmology, Byers Eye Institute, Stanford School of Medicine, Palo Alto, CA.
| | - Daniel Vail
- Department of Ophthalmology, Byers Eye Institute, Stanford School of Medicine, Palo Alto, CA
| | - Cassie A Ludwig
- Department of Ophthalmology, Byers Eye Institute, Stanford School of Medicine, Palo Alto, CA; Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA
| | - Ahmad Al-Moujahed
- Department of Ophthalmology, Byers Eye Institute, Stanford School of Medicine, Palo Alto, CA
| | | | - Marco H Ji
- Department of Ophthalmology, Byers Eye Institute, Stanford School of Medicine, Palo Alto, CA; Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Natalia F Callaway
- Department of Ophthalmology, Byers Eye Institute, Stanford School of Medicine, Palo Alto, CA
| | - Darius M Moshfeghi
- Department of Ophthalmology, Byers Eye Institute, Stanford School of Medicine, Palo Alto, CA
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Hokkinen K, Kaarniranta K, Jämsen E, Lampela P, Hartikainen S, Tolppanen A. Incidence of cataract surgeries in people with and without Alzheimer's disease. Acta Ophthalmol 2022; 100:68-73. [PMID: 33988311 DOI: 10.1111/aos.14896] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Revised: 03/17/2021] [Accepted: 04/18/2021] [Indexed: 02/02/2023]
Abstract
PURPOSE To investigate the incidence of cataract surgeries in relation to Alzheimer's disease (AD) diagnosis and to compare it with that in people without AD. METHODS The MEDALZ-study includes community-dwelling Finnish persons who received clinically verified AD diagnoses (n = 70718) during 2005-2011 and a matched comparison cohort without AD (n = 70718). The cataract surgeries were identified from the Care Register for Healthcare (1996-2015) using NOMESCO surgical procedure codes CJE (10,15,20,25,99), CJF (00,10,20,30,40,45,50,55,99) and CJG (00,05,10,15,20,25,99). The incidence rates for surgeries per 100 person-years were calculated from 10 years before to 3 years after the index date (date of AD diagnosis from the Special Reimbursement Register). RESULTS 25 763 cataract procedures were performed on persons with AD and 26 254 on persons without AD during the follow-up. The incidence of surgery increased similarly in both groups before the index date of AD diagnosis, and the rate of surgery was similar in people with and without AD (3.5 and 3.3/100 person-years, respectively). The incidence diminished steeply in the AD group already one year after the index date, whereas the slow increase continued in the non-AD group. After the index date, the rates were 3.7 and 4.7/100 person-years in people with and without AD. CONCLUSION The diminishing surgery rate very soon after AD diagnosis is concerning. The stigma of AD diagnosis may lead to fewer referrals to surgery, although these patients are expected to benefit from surgery.
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Affiliation(s)
- Kaisa Hokkinen
- Kuopio Research Centre of Geriatric Care School of Pharmacy University of Eastern Finland Kuopio Finland
| | - Kai Kaarniranta
- Department of Ophthalmology Institute of Clinical Medicine University of Eastern Finland and Kuopio University Hospital Kuopio Finland
| | - Esa Jämsen
- Faculty of Medicine and Health Technology and Gerontology Research Centre GEREC Tampere University, and Centre of Geriatrics Tampere University Hospital Tampere Finland
| | - Pasi Lampela
- Kuopio Research Centre of Geriatric Care University of Eastern Finland Kuopio Finland
- School of Pharmacy University of Eastern Finland, and Finnish Student Health Service Kuopio Finland
| | - Sirpa Hartikainen
- Kuopio Research Centre of Geriatric Care School of Pharmacy University of Eastern Finland Kuopio Finland
| | - Anna‐Maija Tolppanen
- Kuopio Research Centre of Geriatric Care School of Pharmacy University of Eastern Finland Kuopio Finland
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Gadzhanova S, Gillam M, Roughead E. Risk of falls and injuries requiring hospitalisation after first-eye cataract surgery in elderly Australians. Acta Ophthalmol 2020; 98:e495-e498. [PMID: 31654472 DOI: 10.1111/aos.14286] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Accepted: 10/03/2019] [Indexed: 12/24/2022]
Abstract
PURPOSE To investigate the impact of the type of the intraocular lenses (IOLs) in first-eye cataract surgery in elderly people on the risk of hospitalisation due to falls and injuries. METHODS A retrospective cohort study was conducted using the Australian Government Department Veterans' Affairs claims data. All people aged 65 years and above who had first cataract surgery between January 2007 and July 2017 were identified. Two cohorts were established depending on the type of IOL-monofocal and multifocal. The risk of injuries and falls requiring hospitalisation in the first 3 months post the surgery was assessed using Cox proportional hazard models with age at entry as primary time scale and adjusting for gender, comorbidities and prior history of falls. RESULTS There were 45 728 people across the two cohorts with the majority receiving monofocal lenses (97%), followed by multifocal lenses (3%) at the time of first cataract surgery. The risk of injury and falls was lower (but not significant) in the multifocal cohort compared to monofocal cohort (adjusted hazard ratio (aHR) 0.56, 95% CI 0.26-1.17). The risk was also lower (but not significant) when stratifying by age group at the time of the surgery. CONCLUSIONS Regardless of age, multifocal lenses did not appear to be associated with the higher risk of serious injuries and falls after first-eye cataract surgery compared to monofocal lenses.
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Affiliation(s)
- Svetla Gadzhanova
- Quality Use of Medicines and Pharmacy Research Centre University of South Australia Adelaide SA Australia
| | - Marianne Gillam
- Quality Use of Medicines and Pharmacy Research Centre University of South Australia Adelaide SA Australia
| | - Elizabeth Roughead
- Quality Use of Medicines and Pharmacy Research Centre University of South Australia Adelaide SA Australia
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Paz LPDS, Borges LDL, Marães VRFDS, Gomes MMF, Bachion MM, Menezes RLD. Factors associated with falls in older adults with cataracts. CIENCIA & SAUDE COLETIVA 2018; 23:2503-2514. [PMID: 30137120 DOI: 10.1590/1413-81232018238.14622016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Accepted: 09/02/2016] [Indexed: 12/16/2022] Open
Abstract
The aim of the present study was to evaluate factors associated with falls in community-dwelling older adults diagnosed with cataracts. An analytical, cross-sectional study was conducted with a sample of community-dwelling older adults residing in the Federal District of Brazil. Interviews and assessment tools were administered, such as the Timed Up and Go test, Short Physical Performance Battery (SPPB), Biodex Balance System, Katz Index, Lawton Scale, Minnesota Leisure Time Physical Activity Questionnaire and Mini Mental State Examination. Statistical analysis involved binary logistic regression. One hundred forty-two older adults (85 with cataracts) participated in the study (mean age: 69.39 ± 5.67 years). Falls were associated with the female sex (OR: 4.45) and sub-maximum score on the SPPB (OR: 3.53) among patients with cataracts, whereas multimorbidity (OR: 5.10) was the risk factor risk for older adults without cataracts. The data suggest different risk factors for falls among older adults diagnosed with cataracts.
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Affiliation(s)
- Leonardo Petrus da Silva Paz
- Faculdade de Ceilândia, Universidade de Brasília (UnB). Universidade de Brasília,. QNN14 AE CEI-Sul, Guariroba. 72220-140 Brasília DF Brasil.
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Schlenker MB, Thiruchelvam D, Redelmeier DA. Association of Cataract Surgery With Traffic Crashes. JAMA Ophthalmol 2018; 136:998-1007. [PMID: 29955857 PMCID: PMC6142973 DOI: 10.1001/jamaophthalmol.2018.2510] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2018] [Accepted: 05/04/2018] [Indexed: 01/19/2023]
Abstract
Importance Cataracts are the most common cause of impaired vision worldwide and may increase a driver's risk of a serious traffic crash. The potential benefits of cataract surgery for reducing a patient's subsequent risk of traffic crash are uncertain. Objective To conduct a comprehensive longitudinal analysis testing whether cataract surgery is associated with a reduction in serious traffic crashes where the patient was the driver. Design, Setting, and Participants Population-based individual-patient self-matching exposure-crossover design in Ontario, Canada, between April 1, 2006, and March 31, 2016. Consecutive patients 65 years and older undergoing cataract surgery (n = 559 546). Interventions First eye cataract extraction surgery (most patients received second eye soon after). Main Outcomes and Measures Emergency department visit for a traffic crash as a driver. Results Of the 559 546 patients, mean (SD) age was 76 (6) years, 58% were women (n = 326 065), and 86% lived in a city (n = 481 847). A total of 4680 traffic crashes (2.36 per 1000 patient-years) accrued during the 3.5-year baseline interval and 1200 traffic crashes (2.14 per 1000 patient-years) during the 1-year subsequent interval, representing 0.22 fewer crashes per 1000 patient-years following cataract surgery (odds ratio [OR], 0.91; 95% CI, 0.84-0.97; P = .004). The relative reduction included patients with diverse characteristics. No significant reduction was observed in other outcomes, such as traffic crashes where the patient was a passenger (OR, 1.03; 95% CI, 0.96-1.12) or pedestrian (OR, 1.02; 95% CI, 0.88-1.17), nor in other unrelated serious medical emergencies. Patients with younger age (OR, 1.27; 95% CI, 1.13-1.14), male sex (OR, 1.64; 95% CI, 1.46-1.85), a history of crash (baseline OR, 2.79; 95% CI, 1.94-4.02; induction OR, 4.26; 95% CI, 2.01-9.03), more emergency visits (OR, 1.34; 95% CI, 1.19-1.52), and frequent outpatient physician visits (OR, 1.17; 95% CI, 1.01-1.36) had higher risk of subsequent traffic crashes (multivariable model). Conclusions and Relevance This study suggests that cataract surgery is associated with a modest decrease in a patient's subsequent risk of a serious traffic crash as a driver, which has potential implications for mortality, morbidity, and costs to society.
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Affiliation(s)
- Matthew B. Schlenker
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada
- Kensington Vision and Research Centre, Toronto, Ontario, Canada
- Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
- Institute for Better Health, Trillium Health Partners, Mississauga, Ontario, Canada
| | - Deva Thiruchelvam
- Evaluative Clinical Sciences Program, Sunnybrook Research Institute, Toronto, Ontario, Canada
- Institute for Clinical Evaluative Sciences in Ontario, Toronto, Ontario, Canada
| | - Donald A. Redelmeier
- Evaluative Clinical Sciences Program, Sunnybrook Research Institute, Toronto, Ontario, Canada
- Institute for Clinical Evaluative Sciences in Ontario, Toronto, Ontario, Canada
- Department of Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
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Palagyi A, Morlet N, McCluskey P, White A, Meuleners L, Ng JQ, Lamoureux E, Pesudovs K, Stapleton F, Ivers RQ, Rogers K, Keay L. Visual and refractive associations with falls after first-eye cataract surgery. J Cataract Refract Surg 2017; 43:1313-1321. [DOI: 10.1016/j.jcrs.2017.07.029] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Revised: 07/04/2017] [Accepted: 07/11/2017] [Indexed: 10/18/2022]
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Clark A, Ng JQ, Morlet N, Semmens JB. Big data and ophthalmic research. Surv Ophthalmol 2016; 61:443-65. [DOI: 10.1016/j.survophthal.2016.01.003] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2015] [Revised: 01/16/2016] [Accepted: 01/25/2016] [Indexed: 02/07/2023]
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Schlenker MB, Thiruchelvam D, Redelmeier DA. Intravitreal anti-vascular endothelial growth factor treatment and the risk of thromboembolism. Am J Ophthalmol 2015; 160:569-580.e5. [PMID: 26116264 DOI: 10.1016/j.ajo.2015.06.011] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2015] [Revised: 06/14/2015] [Accepted: 06/16/2015] [Indexed: 11/27/2022]
Abstract
PURPOSE To evaluate the subsequent risk of thromboembolic events in patients receiving intravitreal ranibizumab and bevacizumab for age-related macular degeneration or macular edema. DESIGN Population-based crossover analysis with self-matched historical control data. METHODS setting: Ontario, Canada, between April 1, 2006, and March 31, 2013. STUDY POPULATION Consecutive patients 65 and older who initiated intravitreal treatment (N = 57 919). INTERVENTION Intravitreal injection of ranibizumab or bevacizumab. MAIN OUTCOME MEASURES Emergency visits for thromboembolic events spanning 1-4 years before treatment were compared to 1 year after treatment. Also examined were other secondary events including hip fractures, congestive heart failure, angina, falls, depression, cholecystitis, and total emergencies, as well as a control group following cataract surgery. RESULTS A total of 57 919 patients were included who accounted for 1858 thromboembolic emergencies (48 per month) during the 3-year Baseline interval and 1077 thromboembolic emergencies (83 per month) during the 1-year Subsequent interval after initiating treatment. The absolute change in risk equaled an increase from 10.7 to 18.6 per 1000 patients annually after initiation of treatment (rate ratio 1.74; 95% confidence interval 1.58-1.92; P < .0001). The relative increase was particularly pronounced for ischemic stroke (rate ratio 2.18; 95% confidence interval 1.94-2.46; P < .0001). The observed increase exceeded trends due to aging, applied across patients with diverse characteristics, occurred with each medication (ranibizumab and bevacizumab), was not apparent for emergencies unrelated to thromboembolic events, and did not occur in a control group following cataract surgery. CONCLUSIONS Intravitreal anti-vascular endothelial growth factor medications ranibizumab and bevacizumab may contribute to systemic thromboembolic events in patients aged 65 years or older.
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Affiliation(s)
- Matthew B Schlenker
- Department of Ophthalmology & Vision Sciences, University of Toronto, Toronto, Canada.
| | - Deva Thiruchelvam
- Evaluative Clinical Sciences Program, Sunnybrook Research Institute, Toronto, Canada; Institute for Clinical Evaluative Sciences in Ontario, Toronto, Canada
| | - Donald A Redelmeier
- Department of Medicine, University of Toronto, Toronto, Canada; Evaluative Clinical Sciences Program, Sunnybrook Research Institute, Toronto, Canada; Institute for Clinical Evaluative Sciences in Ontario, Toronto, Canada; Division of General Internal Medicine, Sunnybrook Health Sciences Centre, Toronto, Canada
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Meuleners LB, Fraser ML, Ng J, Morlet N. The impact of first- and second-eye cataract surgery on injurious falls that require hospitalisation: a whole-population study. Age Ageing 2014; 43:341-6. [PMID: 24192250 DOI: 10.1093/ageing/aft177] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND cataract is a leading cause of reversible vision impairment and may increase falls in older adults. OBJECTIVE to assess the risk of an injury due to a fall among adults aged 60+, 2 years before first-eye cataract surgery, between first-eye surgery and second-eye surgery and 2 years after second-eye surgery. DESIGN a retrospective cohort study. SETTING Western Australian Hospital Morbidity Data System and the Western Australian Death Registry. SUBJECTS there were 28,396 individuals aged 60+ years who underwent bilateral cataract surgery in Western Australia between 2001 and 2008. METHODS Poisson regression analysis based on generalised estimating equations compared the frequency of falls 2 years before first-eye cataract surgery, between first- and second-eye surgery and 2 years after second-eye cataract surgery after accounting for potential confounders. RESULTS the risk of an injurious fall that required hospitalisation doubled (risk ratio: 2.14, 95% confidence interval: 1.82 to 2.51) between first- and second-eye cataract surgery compared with the 2 years before first-eye surgery. There was a 34% increase in the number of injurious falls that required hospitalisation in the 2 years after second-eye cataract surgery compared with the 2 years before first-eye surgery (risk ratio: 1.34, 95% confidence interval: 1.16-1.55). CONCLUSIONS there was an increased risk of injurious falls after first- and second-eye cataract surgery which has implications for the timely provision of second-eye surgery as well as appropriate refractive management between surgeries.
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Affiliation(s)
- Lynn B Meuleners
- School of Public Health, Curtin-Monash Accident Research Centre, Curtin University, Perth, Western Australia, Australia
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To KG, Meuleners L, Bulsara M, Fraser ML, Duong DV, Do DV, Huynh VAN, Phi TD, Tran HH, Nguyen ND. A longitudinal cohort study of the impact of first- and both-eye cataract surgery on falls and other injuries in Vietnam. Clin Interv Aging 2014; 9:743-51. [PMID: 24812501 PMCID: PMC4011894 DOI: 10.2147/cia.s61224] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Aim Little information exists on the impact of cataract surgery on falls and other injuries in Vietnam. The aim of this study was to determine the impact of first and both eye cataract surgery on the number of falls and other injuries among bilateral cataract patients in Ho Chi Minh City, Vietnam. Materials and methods A longitudinal cohort study was conducted involving 413 bilateral cataract patients aged 50+ years. Participants were assessed at three time points: 1 week before, 1–3 months after, and 1 year after first-eye cataract surgery. Visual measures (visual acuity, contrast sensitivity and stereopsis) were taken, and self-reported falls and injury data were collected. A multilevel longitudinal Poisson regression model was used to investigate change in the number of falls after surgery. Results The risk of falls decreased by 78% (incidence-rate ratio [IRR] 0.22, 95% confidence interval [CI] 0.06–0.77; P=0.018) in the year after cataract surgery for participants who had first-eye surgery only and 83% (IRR 0.17, 95% CI 0.04–0.69; P=0.012) for participants who had the second eye operated on compared to before surgery. The risk of falls was three times higher for females than males (IRR 3.13, 95% CI 1.53–6.40; P=0.002). Improved binocular contrast sensitivity was also associated with a decrease in falls (IRR 0.40, 95% CI 0.17–0.97; P=0.042). The prevalence of other injuries also decreased after cataract surgery. Conclusion Cataract surgery reduced the number of falls and other injuries in Vietnam. Contrast sensitivity may be important for ophthalmologists to consider when prioritizing patients for surgery and assessing their fall risk.
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Affiliation(s)
- Kien Gia To
- Curtin Monash Accident Research Centre (C-MARC), Faculty of Health Sciences, Curtin University, Perth, WA, Australia ; University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam
| | - Lynn Meuleners
- Curtin Monash Accident Research Centre (C-MARC), Faculty of Health Sciences, Curtin University, Perth, WA, Australia
| | - Max Bulsara
- Institute for Health Research, University of Notre Dame, Fremantle, WA, Australia
| | - Michelle L Fraser
- Curtin Monash Accident Research Centre (C-MARC), Faculty of Health Sciences, Curtin University, Perth, WA, Australia
| | | | - Dung Van Do
- University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam
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Ishikawa T, Desapriya E, Puri M, Kerr JM, Hewapathirane DS, Pike I. Evaluating the benefits of second-eye cataract surgery among the elderly. J Cataract Refract Surg 2014; 39:1593-603. [PMID: 24075161 DOI: 10.1016/j.jcrs.2013.08.033] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2012] [Revised: 01/16/2013] [Accepted: 03/09/2013] [Indexed: 11/18/2022]
Abstract
UNLABELLED The aim of this systematic review was to synthesize and appraise the evidence of benefits of second-eye cataract extraction for visual function, patient-reported quality of life, falls, and driving ability among the elderly. We conducted a comprehensive search in MEDLINE using "surgery," "cataract extraction," "second eye," and "bilateral." Ten studies met the inclusion and quality criteria. We found "moderate" evidence supporting improvement in stereopsis, stereoacuity, and anisometropia over and above the benefits of first-eye surgery. We also found "moderate" evidence supporting improvement in visual acuity, contrast sensitivity, and self-reported visual functioning. Studies included in the review do not provide definitive evidence of second-eye surgery benefits on health-related quality of life, visual fields, falls prevention, and driving performance. However, the heterogeneity of outcome measures and the limited number of studies likely contributed to our findings. The findings have implications for clinicians and policymakers in the health-care industry and emphasize the need for additional trials examining this important and widely performed clinical procedure. FINANCIAL DISCLOSURE No author has a financial or proprietary interest in any material or method mentioned.
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Affiliation(s)
- Takuro Ishikawa
- From the British Columbia Injury Research and Prevention Unit (Ishikawa, Kerr, Pike), Child and Family Research Institute, British Columbia Children's Hospital, the Department of Pediatrics (Ishikawa, Pike, Puri), Department of Emergency Medicine (Desapriya), University of British Columbia, Vancouver General Hospital/Centre for Clinical Epidemiology and Evaluations, and MD Undergraduate Program (Kerr, Hewapathirane), Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
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To KG, Meuleners LB, Fraser ML, Do DV, Duong DV, Huynh VAN, To QG, Phi TD, Tran HH, Nguyen ND. Prevalence and visual risk factors for falls in bilateral cataract patients in Ho Chi Minh City, Vietnam. Ophthalmic Epidemiol 2014; 21:79-85. [PMID: 24568591 DOI: 10.3109/09286586.2014.885058] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE To determine the prevalence of falls in the 12 months prior to cataract surgery and examine the associations between visual and other risk factors and falls among older bilateral cataract patients in Vietnam. METHODS Data collected from 413 patients in the week before scheduled cataract surgery included a questionnaire and three objective visual tests. RESULTS The outcome of interest was self-reported falls in the previous 12 months. A total of 13% (n = 53) of bilateral cataract patients reported 60 falls within the previous 12 months. After adjusting for age, sex, race, employment status, comorbidities, medication usage, refractive management, living status and the three objective visual tests in the worse eye, women (odds ratio, OR, 4.64, 95% confidence interval, CI, 1.85-11.66), and those who lived alone (OR 4.51, 95% CI 1.44-14.14) were at increased risk of a fall. Those who reported a comorbidity were at decreased risk of a fall (OR 0.43, 95% CI 0.19-0.95). Contrast sensitivity (OR 0.31, 95% CI 0.10-0.95) was the only significant visual test associated with a fall. These results were similar for the better eye, except the presence of a comorbidity was not significant (OR 0.45, 95% CI 0.20-1.02). Again, contrast sensitivity was the only significant visual factor associated with a fall (OR 0.15, 95% CI 0.04-0.53). CONCLUSION Bilateral cataract patients in Vietnam are potentially at high risk of falls and in need of falls prevention interventions. It may also be important for ophthalmologists and health professionals to consider contrast sensitivity measures when prioritizing cataract patients for surgery and assessing their risk of falls.
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Affiliation(s)
- Kien Gia To
- University of Medicine and Pharmacy , Ho Chi Minh City , Vietnam
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The impact of cataract surgery on depressive symptoms for bilateral cataract patients in Ho Chi Minh City, Vietnam. Int Psychogeriatr 2014; 26:307-13. [PMID: 24230965 DOI: 10.1017/s1041610213001907] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Depression is common among older populations with cataract. However, the impact of cataract surgery on depression in both developed and developing countries remains unclear. The aim of this study is to determine the impact of cataract surgery on depressive symptoms and to examine the association between objective visual measures and change in depressive symptoms after surgery among a Vietnamese population in Ho Chi Minh City. METHODS A cohort of older patients with bilateral cataract were assessed the week before and one to three months after first eye surgery only or first- and second-eye cataract surgeries. Visual measures including visual acuity, contrast sensitivity, and stereopsis were obtained. Depressive symptoms were assessed using the 20-item Center for Epidemiological Studies-Depression Scale (CES-D). Descriptive analyses and a generalized estimating equations (GEE) analysis were undertaken to determine the impact of cataract surgery on depressive symptoms. RESULTS Four hundred and thirteen participants were recruited into the study before cataract surgery. Two hundred and forty-seven completed the follow-up assessment after surgery. There was a significant decrease (improvement) of one point in the depressive symptoms score (p = 0.04) after cataract surgery, after accounting for potential confounding factors. In addition, females reported a significantly greater decrease (improvement) of two points in depressive symptom scores (p = 0.01), compared to males. However, contrast sensitivity, visual acuity, and stereopsis were not significantly associated with change in depressive symptoms scores. First-eye cataract surgery or both-eye cataract surgery did not modify the change in depressive symptoms score. CONCLUSION There was a small but significant improvement in depressive symptoms score after cataract surgery for an older population in Vietnam.
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Keay L, Palagyi A, McCluskey P, Lamoureux E, Pesudovs K, Lo S, Ivers R, Boufous S, Morlet N, Ng JQ, Stapleton F, Fraser M, Meuleners L. Falls in Older people with Cataract, a longitudinal evalUation of impact and riSk: the FOCUS study protocol: Table 1. Inj Prev 2014; 20:e7. [DOI: 10.1136/injuryprev-2013-041124] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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