Is Cataract Surgery in Women Associated with Decreased Mortality?
BACKGROUND AND PURPOSE:
Previous studies have found an association between cataract surgery and mortality risk
These studies did not look at mortality outcome with respect to different medical disorders
There are sex differences related to eye health
Approximately 7% more women are blind and 33% more are vision-impaired vs men
Tseng et al. (JAMA Ophthalmology, 2018) examined the possible associated between cataract surgery and total and cause-specific mortality in older women with cataracts using the WHI database
Prospective cohort study
US postmenopausal women aged 50 to 79 years
4 overlapping RCTs that assessed hormone therapy, diet modification, and calcium and vitamin D supplementation (68,132 women) and observational study cohort (93,676 women)
Participants in experimental group: Patients were at least 65 years old with ICD9 and CPT coding for cataracts
All-cause mortality and mortality attributed to vascular, cancer, accidental, neurologic, pulmonary, and infectious causes
Study cohort: 74,044 women with cataract
41,735 were in the cataract surgery group and 32,309 were in the cataract diagnosis group
Mean (SD) age was 70.5 (4.6) years
In covariate-adjusted Cox models, cataract surgery was associated with lower all-cause mortality
Adjusted hazard ratio [AHR] 0.40 (95% CI, 0.39-0.42)
Cataract surgery was associated with lower mortality specific to the following diseases
Vascular (AHR, 0.42; 95% CI, 0.39-0.46)
Cancer (AHR, 0.31; 95% CI, 0.29-0.34)
Accidental (AHR, 0.44; 95% CI, 0.33-0.58)
Neurologic (AHR, 0.43; 95% CI, 0.36-0.53)
Pulmonary (AHR, 0.63; 95% CI, 0.52-0.78)
Infectious (AHR, 0.44; 95% CI, 0.36-0.54)
Adjusting for confounders, cataract surgery was associated with a 60% reduction in overall mortality, and 37% to 69% reduction in mortality due to other disorders, including pulmonary disease and cancer
Further study is needed to assess the underlying mechanism to explain these results
Regardless of mechanism, this study demonstrates the importance of access to cataract surgery for older women
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Disclosure of Unlabeled Use
This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications.
The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.
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presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.
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