Vision improvement and reduction in falls after expedited cataract surgery Systematic review and metaanalysis

Abstract

Purpose: To quantify the benefits of expedited cataract surgery in improving visual acuity and reducing fall-related injuries in the older population.

Setting: Developmental Neurosciences and Child Health: Neurons to Neighbourhoods, Vancouver, British Columbia, Canada.

Methods: A systematic review of the literature was conducted. Studies were included if expedited cataract surgery was presented as a measure to enhance vision and to reduce injury. Published and unpublished studies with any type of study design were included. Studies were identified from 12 databases including Medline (1950 to 2008) and Embase (1980 to 2008). The metaanalysis was specific to randomized controlled trials (RCTs).

Results: The review comprised 737 participants. Sufficient data for the metaanalysis were available to evaluate the impact of expedited cataract surgery on improved visual acuity and a reduced fall rate. Twenty-two publications that included RCTs and prospective cohort studies met the inclusion criteria. Three studies evaluated visual acuity after expedited routine cataract surgery and routine cataract surgery. The pooled estimate showed that expedited cataract surgery increased visual acuity by more than 7 times (odds ratio [OR], 7.22; 95% confidence interval [CI], 3.16-16.55; P<.0001). Pooling of data from 2 RCTs of 535 participants showed a nonsignificant reduction in the incidence of falls after expedited cataract surgery (OR, 0.81; 95% CI, 0.55-1.17).

Conclusions: Accumulating evidence indicates that expedited cataract surgery is effective in significantly enhancing vision but is inconclusive in preventing falls.

Financial disclosure: No author has a financial or proprietary interest in any material or method mentioned.