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Surgery Cuts Motor Accident Rate of Older Adults with Cataracts

Older patients with cataracts who have surgery and intraocular lens implantation are involved in half the car accidents of those who do not have surgery, United States researchers report.

Despite increased crash rates in older drivers compared to middle-aged drivers, few primary prevention interventions focus on the older driver, point out investigators from University of Alabama at Birmingham, in Birmingham, Alabama. The effectiveness of proposed interventions -- education and cognitive training, for example -- has not been determined.

They suggest another method of reducing automobile crashes involving older people might be the treatment of chronic diseases and conditions that cause functional impairments.

"Improvement in vision through cataract surgery and intraocular lens implantation is an example of this approach," they state. "The results [of this study] suggest that it could have widespread benefit to driver safety in our society, given the increase in the older driver population and the high prevalence of cataract in the population older than 65 years."

The researchers enrolled 277 patients with cataracts in a prospective cohort study. Participants from 55 to 84 years of age were recruited from 12 Alabama eye clinics between October 1994 and March 1996.

A total of 174 participants who had surgery and 103 who did not were followed from four to six years to determine the impact of cataract surgery on their crash risk.

When the researchers adjusted for race and baseline visual acuity and contrast sensitivity they found that participants who had cataract surgery had a rate ratio for crashes of 0.47 (95 percent confidence interval, 0.23-0.94), compared to those who did not have surgery.
JAMA, 2002; 288: 841-849. "Impact of Cataract Surgery on Motor Vehicle Crash Involvement by Older Adults"

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