Impact of Cataract Surgery on Postural Control and Fall Risk in Adults and the Elderly: A Systematic Review

Background: Cataracts are a major cause of reversible visual impairment worldwide, particularly among older adults. Visual deterioration associated with cataracts may compromise spatial perception, postural control, and balance, thereby increasing the risk of falls. In this context, cataract surgery has emerged not only as an effective intervention for visual rehabilitation but also as a potential strategy to improve mobility and functional performance in aging populations. Objective: The objective of this study was to systematically evaluate the impact of cataract surgery on postural control, balance, and fall risk in adults and older individuals by comparing preoperative and postoperative outcomes. Methods: A systematic review was conducted following a protocol registered in PROSPERO. Searches were initially conducted in PubMed, Web of Science, Cochrane Library, and Scopus on 20 October 2025, and rerun on 10 March 2026, which was considered the final search date. Twelve studies were included, encompassing prospective cohorts, retrospective population-based analyses, and comparative studies. The certainty of evidence was assessed using the GRADE framework, and the methodological quality of individual studies was evaluated using JBI critical checklists. Results: The included studies generally reported improvements in visual function following cataract surgery, while several studies also reported favorable changes in postural stability, functional balance, and fall-related outcomes. However, findings varied according to study design, outcome definition, surgical timing, and follow-up period. Some studies reported more favorable fall-related and postural outcomes after second-eye surgery; however, the observational nature of the evidence and heterogeneity across studies preclude determining whether bilateral surgery itself caused these improvements. Conclusions: Cataract surgery appears to be associated with improved visual and postural function and, in several studies, with reduced fall incidence, particularly after bilateral correction. However, due to substantial heterogeneity, the predominance of observational evidence, and discordant findings on severe injurious outcomes, the certainty of this effect remains limited. The procedure should be regarded as a component of visual rehabilitation that may coincide with reduced fall risk in selected contexts, rather than a universal prevention strategy. Further prospective studies with standardized outcomes are needed to clarify the relationship between cataract surgery, visual function, postural control, and fall-related outcomes.