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J. A. Gresset, E. E. Freeman, F. Djafari, M.-J. Aubin, R. Bruen, S. Couture, H. Boisjoly; Reported Accidents Attributed to Vision While Waiting for Cataract Surgery in Montreal, Quebec. Invest. Ophthalmol. Vis. Sci. 2008;49(13):1934.
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Over the last 8 years, the median wait for cataract surgery in Montreal, Quebec has decreased from 5 months to 4 months with improved funding and surgical technology. The goals for this analysis were to document the percentage of people who reported an accident that they attributed to their vision while waiting for cataract surgery and to identify the risk factors.
Patients awaiting cataract surgery were recruited from Maisonneuve-Rosemont Hospital in Montreal, Quebec from 1999-2000 (n=509) and a second cohort from 2006-2007 (n=163). About 2 weeks before surgery, patients completed an interviewer-administered questionnaire. One question asked in French "while waiting for cataract surgery, did you have an accident caused by your vision problem (such as a fall, burn, etc)". If an accident was reported, further questions were asked about the severity and the type of accident. Date of entry onto the hospital waiting list and date of cataract surgery were recorded. Best-corrected visual acuity was measured in each eye using an ETDRS acuity chart and was converted to logMAR. The 5-item Cataract Symptom Scale (CSS5) was given. Logistic regression was used to determine independent risk factors for an accident in each cohort. The cohorts were then combined since the odds ratios in each cohort were similar in magnitude.
The median wait time for cataract surgery was 153 days (5.1 months) in 1999-00 and 119 days (4.0 months) in 2006-07. 13% (n=65) of patients reported an accident in the first cohort while only 5% (n=8) reported an accident in the second cohort. Of the 73 total accidents, 38 were falls (52%), 5 were auto accidents (7%), and 3 were burns (4%). Only 9 reported a visit to a doctor or a hospital. In a logistic regression model adjusted for age and cohort, risk factors for a self-reported accident attributed to a vision problem during the wait time were length of wait time (OR=1.09 per 30 days, p=0.004), visual acuity in the eye to be operated on (OR=1.08 per 0.1 logMAR, p<0.001), and worse CSS5 score (OR=1.15, p<0.001).
These data indicate that a longer wait for cataract surgery, worse acuity, and worse cataract symptoms are associated with a greater odds of having an accident thought to be due to vision. Although the validity of asking a patient to determine if vision was a cause of their accident is unknown, those waiting for cataract surgery may need to take extra caution in their daily activities.
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