Effect of Cataract Surgery on Frequency of Falls among Older Persons: A Systematic Review and Meta-Analysis

Abstract

Background. Falls are a significant public health problem among older people worldwide. The aim was to perform a new systematic review and meta-analysis to assess whether cataract surgery is effective in reducing the rate of falls in older persons. Methods. The systematic review was performed following the recommendations by the Cochrane Collaboration. Original papers were included with RCT or quasi-experimental design, which described the effect on uni- or bilateral cataract surgery on the rate of falls among people aged 60 or older. Titles and abstracts were reviewed, full-text versions were retrieved, and two independent examiners reviewed them to assess inclusion criteria. All relevant variables were synthesised in an evidence table. Random-effects meta-analyses were performed pooling the trials, and results were expressed as relative risk (RR) and 95% confidence intervals. Results. The initial search reported 99 potential abstracts, and 41 full-text versions were examined. In the end, eight studies were included. Five included patients 65 years of age and older, two patients 55 years and older, and one included patients 50 years or older. Phacoemulsification and intraocular lens implant were performed in all studies. Two were RCT, and six were quasi-experimental. Falls was the main outcome. The six quasi-experimental studies reported that a reduction in the frequency of falls was observed (RR 0.68, 95% CI 0.48–0.96), although heterogeneity was significant (I2 = 74%). Only one RCT reported risk reduction of 34% (RR 0.66, 95% CI 0.45–0.96). Conclusions. This meta-analysis provides evidence that the first cataract surgery reduces the frequency of falls in older people with bilateral cataracts, but a second surgery does not have significant impact.