Schlenker MB, et al. - Authors conducted a comprehensive longitudinal analysis testing if cataract surgery was related to a reduction in serious traffic crashes where the patient was the driver. Findings suggested an association of cataract surgery with a modest decrease in a patient’s subsequent risk of a serious traffic crash as a driver, which has potential implications for mortality, morbidity, and costs to society.

Methods

• Experts conducted a population-based individual-patient self-matching exposure-crossover design in Ontario, Canada, between April 1, 2006, and March 31, 2016.
• They included consecutive patients 65 years and older undergoing cataract surgery (n=559,546).
• The interventions were first eye cataract extraction surgery (most patients received second eye soon after).
• Emergency department visit for a traffic crash as a driver were the main outcomes and measures.

Results

• Findings suggested that out of the 559,546 patients, mean (SD) age was 76 (6) years, 58% were women (n=326,065), and 86% lived in a city (n=481,847).
• As per data, during the 3.5-year baseline interval, a total of 4680 traffic crashes (2.36 per 1000 patient-years) accrued and 1200 traffic crashes (2.14 per 1000 patient-years) occured during the 1-year subsequent interval, representing 0.22 fewer crashes per 1000 patient-years following cataract surgery (odds ratio [OR], 0.91; 95% CI, 0.84-0.97;P=.004).
• Patients with diverse characteristics were included in the relative reduction.
• In other outcomes, such as traffic crashes where the patient was a passenger (OR, 1.03; 95% CI, 0.96-1.12) or pedestrian (OR, 1.02; 95% CI, 0.88-1.17) no significant reduction was observed, nor in other unrelated serious medical emergencies.
• Results demonstrated that higher risk of subsequent traffic crashes (multivariable model) was seen in patients with younger age (OR, 1.27; 95% CI, 1.13-1.14), male sex (OR, 1.64; 95% CI, 1.46-1.85), a history of crash (baseline OR, 2.79; 95% CI, 1.94-4.02; induction OR, 4.26; 95% CI, 2.01-9.03), more emergency visits (OR, 1.34; 95% CI, 1.19-1.52), and frequent outpatient physician visits (OR, 1.17; 95% CI, 1.01-1.36).