Fall risk in patients with pseudophakic monovision.

Autor: Rosenblatt TR; Department of Ophthalmology, Byers Eye Institute, Stanford School of Medicine, Palo Alto, CA. Electronic address: tatianar@stanford.edu., Vail D; Department of Ophthalmology, Byers Eye Institute, Stanford School of Medicine, Palo Alto, CA., Ludwig CA; Department of Ophthalmology, Byers Eye Institute, Stanford School of Medicine, Palo Alto, CA; Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA., Al-Moujahed A; Department of Ophthalmology, Byers Eye Institute, Stanford School of Medicine, Palo Alto, CA., Pasricha MV; Department of Ophthalmology, Byers Eye Institute, Stanford School of Medicine, Palo Alto, CA., Ji MH; Department of Ophthalmology, Byers Eye Institute, Stanford School of Medicine, Palo Alto, CA; Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY., Callaway NF; Department of Ophthalmology, Byers Eye Institute, Stanford School of Medicine, Palo Alto, CA., Moshfeghi DM; Department of Ophthalmology, Byers Eye Institute, Stanford School of Medicine, Palo Alto, CA.
Jazyk: angličtina
Zdroj: Canadian journal of ophthalmology. Journal canadien d'ophtalmologie [Can J Ophthalmol] 2023 Feb; Vol. 58 (1), pp. 11-17. Date of Electronic Publication: 2021 Aug 20.
DOI: 10.1016/j.jcjo.2021.07.010
Abstrakt: Objective: Vision changes can precipitate falls in the elderly resulting in significant morbidity and mortality. We hypothesized that pseudophakic monovision and ensuing anisometropia and aniseikonia impact elderly fall risk. This study assessed fall risk in patients with pseudophakic monovision, pseudophakic single vision distance (classic cataract surgery), and cataracts with no surgery.
Design: Retrospective single-institution cohort study PARTICIPANTS: Patients with bilateral cataracts diagnosed at 60 years of age or older who underwent bilateral cataract surgery (monovision or single vision distance) or did not undergo any cataract surgery (n = 13 385). Patients with unilateral surgery or a fall prior to cataract diagnosis were excluded.
Methods: Data were obtained from the Stanford Research Repository. Time-to-fall analysis was performed across all 3 groups. Primary outcome was hazard ratio (HR) for fall after second eye cataract surgery or after bilateral cataract diagnosis.
Results: Of 13 385 patients (241 pseudophakic monovision, 2809 pseudophakic single vision, 10 335 no surgery), 850 fell after cataract diagnosis. Pseudophakic monovision was not associated with fall risk after controlling for age, sex, and myopia. Pseudophakic single-vision patients had a decreased time to fall compared with no-surgery patients (log rank, p < 0.001). Older age at cataract diagnosis (HR =1.05, 95% confidence interval [CI] 1.04-1.06, p < 0.001) or at time of surgery (HR = 1.05, 95% CI 1.03-1.07, p < 0.001) increased fall risk, as did female sex (HR = 1.29, 95% CI 1.10-1.51, p = 0.002) and preexisting myopia (HR = 1.31, 95% CI 1.01-1.71, p = 0.046) among nonsurgical patients.
Conclusions: Pseudophakic monovision did not impact fall risk, but pseudophakic single vision may increase falls compared with patients without cataract surgery.
(Copyright © 2021 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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