Cataract surgery reduces hip fracture, as well as improving eye sight

By Sarah Guy, MedWire Reporter

Surgery for cataract removal significantly reduces the rate of hip fracture in the year after the procedure compared with no surgery, show study results involving over a million Medicare beneficiaries aged over 65 years.

The association was even stronger among patients with severe cataracts who received surgical treatment compared with their untreated counterparts, say the researchers.

"Visual impairment has been found to be strongly associated with an increased risk of fractures," explain Anne Coleman (University of California at Los Angeles, USA) and co-workers, adding that vision plays a role in postural balance and stability, which is often lost in individuals with cataracts.

"Furthermore, cataracts have been found to be the most common cause of fracture-related visual impairment," writes the team in JAMA.

In a random sample of 1,113,640 Medicare beneficiaries identified between 2002 and 2010 with a diagnosis code indicating cataracts and aged at least 65 years, 410,809 (36.9%) underwent surgery for their condition. Coleman and colleagues compared the incidence of hip fracture and any fracture in these and the 702,831 (63.1%) cataract patients not treated surgically either in the year of treatment, or the year of diagnosis.

Overall, the authors report a respective 1.3% and 5.4% hip and any fracture rate during the study period. After adjustment for factors including age, race, gender, area of residence in the USA, and comorbidities and physically limiting conditions, patients who received cataract surgery were a significant 16% less likely to experience hip fracture than their nonsurgically treated peers.

This association was even stronger in patients with severe cataracts (including anterior and posterior subcapsular cataracts, total, mature and hypermature cataracts, and combined forms of cataract) who had a 23% reduction in odds for hip fracture in the year after surgery.

"Cataract surgery has already been demonstrated to be a cost-effective intervention for visual improvement," note Coleman et al, who add that their results suggest further potential benefits of this procedure to decrease the incidence of fractures in the elderly.

Indeed, adjusted analysis showed that the risk for any fracture was a significant 5% and 8% less among surgery patients with cataract and severe cataract, respectively, compared with their peers with a diagnosis alone.

"Future prospective studies using standardized registries of patients with cataracts will help further elucidate the association between cataract surgery and fracture risk," Coleman and colleagues conclude.

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