Cataract Surgery and the Rate of Traffic Accidents
JAMA Ophthalmology, September 2018
Cataracts are a leading cause of impaired vision worldwide. But do they increase the risk of serious traffic accidents? In a population-based study, Schlenker et al. examined the records of >500,000 patients and found that cataract surgery was associated with a reduced rate of hospital visits due to a traffic crash when the cataract surgery patient was the driver.
This study included Canadian patients 65 years and older who underwent their first cataract surgery between 2006 and 2016. Each patient’s record was tracked for up to 5 years after cataract surgery. The researchers excluded those patients who had cataract surgery combined with retina, glaucoma, or cornea surgery because of uncertain visual recovery.
The mean age of the 559,546 patients was 76 years, and 58% were women. Almost no patient had received a medical warning from his or her physician regarding fitness to operate a vehicle noted in the record. A total of 4,680 traffic crashes occurred during the baseline interval, and 1,200 traffic crashes took place during the follow-up after cataract surgery. This reduction represented 0.22 fewer crashes per 1,000 patient-years when the patient was the driver. No reduction in crashes was observed in other secondary outcomes, including traffic accidents in which the patient was a passenger or pedestrian. With regard to patient subgroups, the researchers found that patients who were younger, were male, had more emergency visits in general, and had more frequent outpatient physician visits were at greater risk of traffic crashes when driving.
These results suggest that improvements in vision following cataract surgery are associated with decreased driving risks. The researchers also noted postsurgery crash rates were highest in the first month, perhaps owing to uncorrected refractive error, adapting to recovery, or overconfidence—a finding that should inform postsurgery physician counseling.
The original article can be found here.