Evaluating the benefits of second-eye cataract surgery among the elderly.
The aim of this systematic review was to synthesize and appraise the evidence of benefits of second-eye cataract extraction for visual function, patient-reported quality of life, falls, and driving ability among the elderly. We conducted a comprehensive search in MEDLINE using "surgery," "cataract extraction," "second eye," and "bilateral." Ten studies met the inclusion and quality criteria. We found "moderate" evidence supporting improvement in stereopsis, stereoacuity, and anisometropia over and above the benefits of first-eye surgery. We also found "moderate" evidence supporting improvement in visual acuity, contrast sensitivity, and self-reported visual functioning. Studies included in the review do not provide definitive evidence of second-eye surgery benefits on health-related quality of life, visual fields, falls prevention, and driving performance. However, the heterogeneity of outcome measures and the limited number of studies likely contributed to our findings. The findings have implications for clinicians and policymakers in the health-care industry and emphasize the need for additional trials examining this important and widely performed clinical procedure.


BACKGROUND
No author has a financial or proprietary interest in any material or method mentioned.
From the British Columbia Injury Research and Prevention Unit (Ishikawa, Kerr, Pike), Child and Family Research Institute, British Columbia Children's Hospital, the Department of Pediatrics (Ishikawa, Pike, Puri), Department of Emergency Medicine (Desapriya), University of British Columbia, Vancouver General Hospital/Centre for Clinical Epidemiology and Evaluations, and MD Undergraduate Program (Kerr, Hewapathirane), Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
Takuro
T
Ishikawa
Ediriweera
E
Desapriya
Maneesh
M
Puri
John M
JM
Kerr
D Sesath
DS
Hewapathirane
Ian
I
Pike
D000058:Accidental Falls / Q000517:prevention & control; D000203:Activities of Daily Living; D001334:Automobile Driving; D002386:Cataract / Q000503:physiopathology*; D002387:Cataract Extraction / Q000379:methods*; D015350:Contrast Sensitivity / Q000502:physiology*; D003867:Depth Perception / Q000502:physiology*; D006304:Health Status; D006801:Humans; D017063:Outcome Assessment, Health Care; D011788:Quality of Life; D014792:Visual Acuity / Q000502:physiology*; D014794:Visual Fields / Q000502:physiology*