July 2018
Volume 59, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2018
Cataract Surgery and Traffic Crashes: Population-based Exposure-Crossover Design
Author Affiliations & Notes
  • Matthew Schlenker
    Ophthalmology & Vision Sciences, University of Toronto, Toronto, Ontario, Canada
    Ophthalmology & Vision Sciences, Kensington Eye Institute, Toronto, Ontario, Canada
  • Deva Thiruchelvam
    Institute of Clinical & Evaluative Sciences, Toronto, Ontario, Canada
  • Don Redelmeier
    Internal Medicine, Sunnybrook, Toronto, Ontario, Canada
    Institute of Clinical & Evaluative Sciences, Toronto, Ontario, Canada
  • Footnotes
    Commercial Relationships   Matthew Schlenker, Alcon (C), Allergan (C), AMO (C), Light Matter Interaction (C); Deva Thiruchelvam, None; Don Redelmeier, None
  • Footnotes
    Support  Senior Author: Canada Research Chair
Investigative Ophthalmology & Visual Science July 2018, Vol.59, 6017. doi:
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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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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : 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.

Methods : 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.

Results : 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.

Conclusions : 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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