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Lynn Meuleners, Michelle Fraser, Jonathon Ng, Nigel Morlet; The impact of first and second eye cataract surgery on hospitalisation from injuries due to a fall: a whole population study. Invest. Ophthalmol. Vis. Sci. 2013;54(15):859.
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To assess the risk of an injury due to a fall among adults aged 60+ years before first eye cataract surgery, between first and second eye surgery and after second eye surgery.
A retrospective cohort study was undertaken using linked data from the Western Australian Hospital Morbidity Data System and the Western Australian Death Registry from 2001 to 2008. Poisson regression analysis based on generalised estimating equations (GEE) was undertaken with each person as the unit of analysis, to compare the frequency of falls two years before first eye, and two years after second eye cataract surgery. To investigate the association of timing of cataract surgery and falls risk, follow up time was divided into three “cataract exposure” periods of time unique to each individual; the two years prior to first eye cataract surgery, the time between first and second cataract surgery and two years after the second cataract surgery. The follow-up was censored accordingly for those who died during the study period.
There were 28,396 individuals aged 60+ years who underwent bilateral cataract surgery in Western Australian between 2001 and 2008. Of this group 1,094 (3.85%) individuals experienced 1,220 injuries due to a fall during the study period. The risk of injury due to a fall doubled (risk ratio 2.14, 95% confidence interval 1.82 to 2.51) between first and second eye cataract surgery compared to the two years before first eye surgery. There was a 34% increase in the number of falls in the two years after second eye cataract surgery compared to the two years before first eye cataract surgery (1.34, 1.16 to 1.55). There was a progressive increase of a fall-related injury with increasing age with the risk in those aged 85+ years 6.84 times (3.93 to 11.93) that of the 60-64 years age group. Women (2.24, 1.91 to 2.63); and those with at least one comorbidity (2.84, 2.46 to 3.29) were also at significantly increased risk of injury due to a fall. Those who were married (RR 0.30, 95% CI 0.60-0.80) had a reduced risk of an injury due to a fall.
There may be an increased risk of falls after cataract surgery which ophthalmologists should consider when discussing risks and benefits of cataract surgery. This has important implications for the timely provision of second eye cataract surgery for older adults.
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