Visual and refractive associations with falls after first-eye cataract surgery

Area of Science:

• Ophthalmology
• Gerontology
• Public Health

Background:

• Falls are a major health concern for older adults, leading to significant morbidity and mortality.
• Cataract surgery is common in the elderly population, but its impact on fall risk is not fully understood.
• Visual impairment from cataracts is a known risk factor for falls.

Purpose of the Study:

• To determine the effect of first-eye cataract surgery on the rate of falls in older adults.
• To identify specific visual function components that contribute to fall risk after surgery.

Main Methods:

• A prospective cohort study was conducted with 329 patients aged 65 years or older awaiting cataract surgery.
• Vision, physical function, and exercise activity were assessed before and after first-eye surgery.
• Falls were prospectively recorded for up to two years, with statistical analysis using generalized linear mixed models.

Main Results:

• First-eye cataract surgery led to a 33% reduction in incident falls (IRR 0.67, P=.01).
• Poorer dominant-eye visual acuity was associated with an increased risk of falls (IRR 2.20, P=.04).
• A change of ±0.75 diopters or more in spectacle correction for the operated eye doubled the incidence of falls post-surgery (IRR 2.17, P=.008).

Conclusions:

• First-eye cataract surgery is effective in reducing fall incidence.
• Significant refractive changes in the operated eye post-surgery can elevate fall risk.
• Judicious postoperative refractive management is crucial for optimizing cataract surgery's role in fall prevention.