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Matthew Schlenker, Deva Thiruchelvam, Don Redelmeier; Cataract Surgery and Traffic Crashes: Population-based Exposure-Crossover Design. Invest. Ophthalmol. Vis. Sci. 2018;59(9):6017.
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Cataracts are the most common cause of visual impairment worldwide and may increase the risk of a serious traffic crash. The potential benefits of cataract surgery on reducing a patient’s subsequent risk of a traffic crash are uncertain. We conducted a comprehensive longitudinal analysis testing whether cataract surgery is associated with a reduction in serious traffic crashes where the patient was the driver.
Design: Population-based individual-patient self-matching exposure-crossover design.Setting: Ontario, Canada, between April 1st, 2006 and March 31st, 2016.Participants: Consecutive patients 65 and older undergoing cataract surgery (n = 559,546).Intervention: First eye cataract extraction surgery (most received second eye soon after).Main Outcome: Emergency department visit for a traffic crash as a driver.
A total of 4,680 traffic crashes (2.36 per 1,000 patients annually) accrued during the three and half-year baseline interval and 1,200 traffic crashes (2.14 per 1,000 patients annually) during the one-year subsequent interval, representing 0.22 fewer crashes per 1,000 patients annually after cataract surgery (odds ratio 0.91; 95% confidence interval 0.84 - 0.97; p = 0.0037). The relative reduction included patients with diverse demographic, ophthalmologic, and medical characteristics. No significant reduction was observed in other outcomes such as traffic crashes where the patient was a passenger or a pedestrian nor in other unrelated serious medical emergencies. Patients with younger age, male gender, a history of crash, more emergency visits, and frequent outpatient physician visits had the highest risk of subsequent traffic crashes.
Cataract surgery is associated with a modest decrease in a patient’s subsequent risk of serious traffic crashes as a driver.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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