Highlights This study measured the impact of cataract surgery on driving simulator performance. Crashes/near crashes decreased by 36% after first eye and 47% after second eye surgery. Time spent speeding decreased after second eye surgery only. This study highlights the importance of timely first and second eye cataract surgery.
Abstract Introduction: This study investigated the separate impact of first eye and second eye cataract surgery on driving performance, as measured on a driving simulator. Method: Forty-four older drivers with bilateral cataract aged 55+ years, awaiting first eye cataract surgery participated in a prospective cohort study. They completed a questionnaire, visual tests and a driving simulator assessment at three time points: before first eye, after first eye, and after second eye cataract surgery. Generalized Estimating Equation Poisson or linear regression models were undertaken to examine the change in four driving outcomes of interest after adjusting for cataract surgery and other potential confounders. Results: The rate of crashes/near crashes decreased significantly by 36% (incidence rate ratio (IRR) 0.64, 95% CI 0.47–0.88, p = 0.01) after first eye surgery and 47% (IRR 0.53, 95% CI 0.35–0.78, p < 0.001) after second eye surgery, compared to before first eye cataract surgery, after accounting for confounders. The rate of crashes/near crashes also decreased with better contrast sensitivity (IRR 0.69, 95% CI 0.48–0.90, p = 0.041). A separate model found that time spent speeding 10 kilometers per hour or more over the limit after second eye surgery was significantly less (0.14 min, p = 0.002), compared to before first eye surgery, after accounting for confounders. As contrast sensitivity improved, the duration of speeding also decreased significantly by 0.46 min (p = 0.038). There were no statistically significant changes in lane excursions or speed variation. Practical applications: The findings highlight the importance of timely first and second eye cataract surgery to ensure driver safety, especially as older drivers wait for second eye cataract surgery. It also provides further evidence that contrast sensitivity is probably a better predictor of driving ability in older drivers with cataract than visual acuity, the measure on which driver licensing requirements are currently based, and should also be used when assessing fitness to drive.
Changes in driving performance after first and second eye cataract surgery: A driving simulator study
Journal of Safety Research ; 78 ; 146-154
2021-04-28
9 pages
Article (Journal)
Electronic Resource
English
ANOVA , analysis of variance , CI , confidence interval , GEE , Generalized Estimating Equations , ETDRS , Early Treatment Diabetic Retinopathy Study , IRR , incidence rate ratio , km , kilometers , km/h , kilometers per hour , logMAR , logarithm of the minimum angle of resolution , MMSE , Mini Mental State Examination , SD , standard deviation , WA , Western Australia , Cataract surgery , Driving performance , Driving simulator , Visual measures
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