TUESDAY, Aug. 20, 2002 (HealthDayNews) -- This isn't an eye-opening revelation, but it's reassuring to know: Cataract surgery among older people cuts in half the risk of being involved in a car crash.
"It is an additional piece of evidence that patients need to be aware of when they are weighing the risk of having cataract surgery," says Cynthia Owsley, a professor of ophthalmology at the University of Alabama at Birmingham. She is the lead author of a paper on the finding, which appears in tomorrow's issue of the Journal of the American Medical Association.
It may seem obvious that someone whose vision is reduced by cataracts -- which means half of all Americans 65 or older -- will do better on the road with surgery, but no one has documented that benefit until now. Cataracts are a clouding of the lens in the eye. When the clouding becomes too dense, surgery is the answer.
"When we counsel our patients about cataract surgery, we must discuss risks and benefits, and until this paper, there was no quantifying evidence about what risks they take if they don't have the surgery," says Dr. Wayne F. Bizer, a spokesman for the American Academy of Ophthalmology.
In the study, Owsley and her colleagues compared the driving records of 277 patients diagnosed with cataracts at 12 eye clinics in Alabama from 1994 to 1996. In a follow-up averaging about five years, the 174 people who had cataract surgery had a 53 percent lower risk of auto crash involvement than the 103 people who didn't have the surgery.
The people who didn't have the surgery drove a lot less than those who did, logging only half the number of passenger miles -- which could be an indication that cataracts were limiting their mobility.
That self-imposed limitation could be important to an older person who wants to remain busy and employed, Owsley says. "If they want an active lifestyle and part of that lifestyle is working, one of the critical issues for them is driving," she notes.
Studies like this are important because many people have an unwarranted fear of cataract surgery, Bizer says.
"When you tell them they need cataract surgery, half of them will fall out of the chair," he says. "Many people find it terribly frightening. They may remember what cataract surgery was in the age of their parents, when you had sandbags on each side of your head and you were in the hospital for two weeks. And some are afraid they might go blind from surgery, which is a very rare occurrence."
Many people don't know about the safety of the procedure. "One idea that may be getting lost is a very low complication rate," she says.
The great majority of cataract operations now are done as outpatient procedures, in which the patient spends only a few hours in the doctor's office or hospital. The medical advances that made outpatient surgery possible have been eagerly seized upon not only by ophthalmologists, but also by cost-conscious health-care providers.
"Medicare made it that way," Bizer says. "To be reimbursed, it has to be outpatient surgery unless there is a co-morbid condition such as diabetes or cardiovascular disease that requires the patient to spend a night in the hospital."
Many factors can influence the decision to have cataract surgery, Owsley says, including other chronic conditions and the availability of family support. However, people considering the procedure should know that "it is one of the safest surgeries we have," she says.
What To Do
Here's more information on cataracts.
This information about cataracts from the National Eye Institute tells you whether you're a candidate for cataract surgery.
