|
 Compared to their chances of a crash before surgery, drivers with
cataracts were 9 percent less likely to be involved in collisions
afterwards, the study found.
Doctors would need to treat 4,564 patients to avoid one crash a
year, researchers report in JAMA Opthalmology.
"Given the mortality and societal costs from traffic crashes, any
reduction in these risks would be welcome," said lead study author
Dr. Matthew Schlenker of the Kensington Eye Institute in Toronto,
Ontario.
Cataracts often develop with age, making the lens inside the eye
cloudy and more opaque and reducing the amount of light that enters
the eye. Symptoms can include decreased visual acuity, impaired
color vision, more glare, and less sense of brightness, contrast and
depth perception in what people see.
Surgery for cataracts typically involves two small incisions to
remove the damaged lens and the insertion of a clear artificial
lens.
"Removing the opacified natural lens allows better light entry,
reduces or eliminates refractive error, and reduces light scatter,"
Schlenker said by email. "While overall the procedure is well
tolerated, there are rare complications including infection,
bleeding, swelling, or retinal detachment."
The study included 559,456 patients who had cataract surgery between
2006 and 2016. They were 76 years old on average.
Patients were behind the wheel in a total of 6,482 serious crashes
that landed them in the emergency room during the five years before
their cataract surgery.
During the 3.5 years before surgery, 2.36 patients out of every
1,000 were drivers in traffic crashes.
Over the course of the first year after surgery, 2.14 patients out
of every 1,000 were drivers involved in collisions.
Cataract surgery was not associated with a lower risk of being
involved in a crash as a passenger or pedestrian.
The study wasn't a controlled experiment designed to prove whether
or how cataract surgery might make crashes less likely, the authors
note. Another limitation is that it only included people with
cataracts severe enough to justify operations, and many people with
cataracts don't get surgery.
[to top of second column] |
Even so, the focus on people who got in traffic crashes serious
enough to require emergency medical treatment offers high-quality
evidence that cataract surgery may be one effective approach to
reducing the risk of these collisions, said Dr. Justine Smith, a
researcher at Flinders University in Adelaide, Australia, who wasn't
involved in the study.
"We know that reduced vision is a risk for driving - that is why the
Department of Motor Vehicles or equivalent takes your driving
license when your vision drops below a set level, which varies with
country," Smith said by email.
"The investigators were able to associate cataract surgery with
decreased risk of a serious traffic accident," Smith added. "This
tells you that if you or an elderly relative develop a cataract that
affects the vision, one good reason to have the cataract operated,
is for road use (car, motorbike or bicycle) safety."
Not everybody with a cataract needs surgery, and not everyone with a
cataract will have difficulty driving safely, noted Dr. Kevin Miller
of the Stein Eye Institute and the David Geffen School of Medicine
at the University of California, Los Angeles.
Other people with cataracts clearly shouldn't be driving at all
because their vision is too impaired to safely operate a vehicle,
Miller, who wasn't involved in the study, said by email.
"The difficulty comes with everybody in between where they have some
cataract and it's creating some effect on their vision but it's not
to the point where they can't pass a driver's vision test," Miller
said. "There are many, many people that fall into that gray zone."
SOURCE: https://bit.ly/2N8JOdt JAMA Ophthalmology, online June 28,
2018.
[© 2018 Thomson Reuters. All rights
reserved.] Copyright 2018 Reuters. All rights reserved. This material may not be published,
broadcast, rewritten or redistributed.
Thompson Reuters is solely responsible for this content.
 |
