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Age and Ageing 2006 35(1):66-71; doi:10.1093/ageing/afj005
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© The Author 2006. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Falls and health status in elderly women following second eye cataract surgery: a randomised controlled trial

Alexander J. E. Foss1, Rowan H. Harwood2, Francis Osborn1, Richard M. Gregson1, Anwar Zaman1 and Tahir Masud2

1 Department of Ophthalmology, University Hospital, Queen’s Medical Centre, Nottingham NG7 2UH, UK
2 Clinical Gerontology Research Unit, City Hospital, Nottingham NG5 1PB, UK

Address correspondence to: R. Harwood. Email: rowan.harwood{at}ntlworld.com

Objective: first eye cataract surgery reduces the risk of falling. Most cataracts in elderly people are bilateral. Some binocular functions (e.g. stereopsis) are associated with falls. We aimed to determine if second eye cataract surgery reduces the risk of falling and to measure associated health gain.

Study design and setting: we randomised 239 women over 70, who had been referred to a hospital ophthalmology department, with one unoperated cataract, to expedited (approximately 4 weeks) or routine (12 months wait) surgery. Falls were ascertained by diary, with follow-up every 3 months for 12 months. We measured health status after 6 months.

Results: visual function (especially stereopsis) improved in the operated group. Over 12 months follow-up, 48 (40%) operated participants fell at least once, 22 (18%) fell more than once. Forty-one (34%) unoperated participants fell at least once, 22 (18%) fell more than once. Rate of falling was reduced by 32% in the operated group, but this was not statistically significant (rate ratio 0.68, 95% CI 0.39, 1.19, P = 0.18). Confidence, visual disability and handicap all improved in the operated compared with the control group.

Conclusion: second eye cataract surgery improves visual disability and general health status. The effect on rate of falling remains uncertain.

Keywords: cataract, elderly, falls, health status, outcome assessment, randomised controlled trial

Received June 17, 2005; accepted in revised form August 14, 2005.


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