title: The impact of first- and second-eye cataract surgery on injurious falls that require hospitalisation: a whole-population study.
abstract: BACKGROUND
  cataract is a leading cause of reversible vision impairment and may increase falls in older adults.
  
  
  OBJECTIVE
  to assess the risk of an injury due to a fall among adults aged 60+, 2 years before first-eye cataract surgery, between first-eye surgery and second-eye surgery and 2 years after second-eye surgery.
  
  
  METHODS
  a retrospective cohort study.
  
  
  METHODS
  Western Australian Hospital Morbidity Data System and the Western Australian Death Registry.
  
  
  METHODS
  there were 28,396 individuals aged 60+ years who underwent bilateral cataract surgery in Western Australia between 2001 and 2008.
  
  
  METHODS
  Poisson regression analysis based on generalised estimating equations compared the frequency of falls 2 years before first-eye cataract surgery, between first- and second-eye surgery and 2 years after second-eye cataract surgery after accounting for potential confounders.
  
  
  RESULTS
  the risk of an injurious fall that required hospitalisation doubled (risk ratio: 2.14, 95% confidence interval: 1.82 to 2.51) between first- and second-eye cataract surgery compared with the 2 years before first-eye surgery. There was a 34% increase in the number of injurious falls that required hospitalisation in the 2 years after second-eye cataract surgery compared with the 2 years before first-eye surgery (risk ratio: 1.34, 95% confidence interval: 1.16-1.55).
  
  
  CONCLUSIONS
  there was an increased risk of injurious falls after first- and second-eye cataract surgery which has implications for the timely provision of second-eye surgery as well as appropriate refractive management between surgeries.
authors.affiliation: School of Public Health, Curtin-Monash Accident Research Centre, Curtin University, Perth, Western Australia, Australia.
authors.forename: Lynn B
authors.initials: LB
authors.lastname: Meuleners
authors.forename: Michelle Louise
authors.initials: ML
authors.lastname: Fraser
authors.forename: Jonathan
authors.initials: J
authors.lastname: Ng
authors.forename: Nigel
authors.initials: N
authors.lastname: Morlet
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control / Q000706:statistics & numerical data; D000368:Aged; D000369:Aged, 80 and over; D001315:Australia / Q000453:epidemiology; D002386:Cataract / Q000150:complications / Q000453:epidemiology; D002387:Cataract Extraction / Q000379:methods / Q000706:statistics & numerical data; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D059035:Perioperative Period / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012307:Risk Factors; D014786:Vision Disorders / Q000150:complications* / Q000453:epidemiology / Q000601:surgery; D014947:Wounds and Injuries / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000628:therapy
keywords: cataract; cataract surgery; falls; injury; older people