June 2022
Volume 63, Issue 7
Open Access
ARVO Annual Meeting Abstract  |   June 2022
Cataract phacoemulsification in people with dementia: Characterization and outcomes.
Author Affiliations & Notes
  • Nathan C. Grove
    University of Colorado School of Public Health Department of Biostatistics & Informatics, Aurora, Colorado, United States
    Sue Anschutz-Rodgers Eye Center, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States
  • Victoria S Pelak
    Sue Anschutz-Rodgers Eye Center, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States
  • Karen L. Christopher
    Sue Anschutz-Rodgers Eye Center, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States
  • Brandie D. Wagner
    University of Colorado School of Public Health Department of Biostatistics & Informatics, Aurora, Colorado, United States
  • Anne M. Lynch
    Sue Anschutz-Rodgers Eye Center, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States
  • Jennifer L. Patnaik
    Sue Anschutz-Rodgers Eye Center, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States
  • Footnotes
    Commercial Relationships   Nathan Grove None; Victoria Pelak None; Karen Christopher None; Brandie Wagner None; Anne Lynch None; Jennifer Patnaik None
  • Footnotes
    Support  Unrestricted Research Grant from Research to Prevent Blindness
Investigative Ophthalmology & Visual Science June 2022, Vol.63, 1684 – F0002. doi:
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      Nathan C. Grove, Victoria S Pelak, Karen L. Christopher, Brandie D. Wagner, Anne M. Lynch, Jennifer L. Patnaik; Cataract phacoemulsification in people with dementia: Characterization and outcomes.. Invest. Ophthalmol. Vis. Sci. 2022;63(7):1684 – F0002.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Cataract surgery in people with dementia (PWD) has been evaluated in the context of claims-based retrospective studies. However, due to limitations of these studies, detailed clinical and surgical information is lacking for this population. This retrospective cohort study characterizes pre-, intra-, and post-operative information from PWD in a cataract surgery outcomes database.

Methods : Demographics, medical and ocular history, surgical characteristics, and postoperative measures were analyzed for differences between PWD and non-PWD cohorts. Patient-level data were analyzed with Fisher’s Exact Test, and eye-level data were analyzed with logistic regression using generalized estimating equations to account for correlation of eyes from the same individual.

Results : 507 eyes from 296 PWD were identified using appropriate ICD codes and cross referenced to a cataract surgery outcomes database containing 12,949 eyes from 7,853 patients who underwent cataract phacoemulsification at a single center between January 2014 and October 2019. PWD were older by almost 5 years (73.4 (SD=11.5) vs. 68.5 (SD=11.1), p<0.001) and all subsequent analyses were adjusted for age. PWD had shorter duration cataract surgeries (18.2 (SD=11.0) min. vs. 20.4 (SD=14.8) min., p=0.010), were more likely to have mature cataract (3.9% vs. 2.4%, p=0.013), and were more likely to have complex surgeries (capsular staining, mechanical pupillary expansion, CTR) (19.9% vs. 15.6%, p=0.028). The rate of general anesthesia was higher in PWD (1.6% vs. 0.7%, p=0.003). There were no differences in complication rates between PWD and non-PWD cohorts. Both preoperative best corrected LogMAR visual acuity (BCVA) (0.454 (SD=0.586) vs. 0.378 (SD=0.519), p<0.001) and postoperative BCVA (0.153 (SD=0.387) vs. 0.096 (SD=0.305) p<0.001) were worse in PWD. BCVA significantly improved in both groups (p<0.001), however, the average magnitude of improvement in BCVA was better in PWD (-0.308 (SD=0.439), vs. -0.286 (SD=0.423), p=0.030).

Conclusions : In this single center analysis, PWD present for cataract surgery at a later age, and were more likely to have mature cataracts, complex surgery, and general anesthesia, but did not have higher rates of complication, and showed significant improvement in BCVA following surgery. These findings should be encouraging to PWD undergoing counseling for cataract surgery, and for the potential for improved function in PWD.

This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.

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