Clinical Comment: One of the most enduring benefits of cataract surgery is the lower incidence or rate of hip fractures following cataract surgery. Not only does vision improve, this lower rate of hip fractures should be an additional benefit that we as optometrists can convey to our patients. Loss of mobility is as frightening to many patients as is vision.
Potter HD., Risk for fractures following cataract surgery. JAMA Ophthalmol. 2013 Feb 1;131(2):242-3. doi: 10.1001/jamaophthalmol.2013.851.
CONTEXT: Visual impairment is a known risk factor for fractures. Little is
known about the association of cataract surgery with fracture risk.
OBJECTIVE: To determine the association of cataract surgery with subsequent
fracture risk in US Medicare beneficiaries with a diagnosis of cataract.
DESIGN, SETTING, AND PARTICIPANTS: Retrospective study of 1-year fracture
incidence in a 5% random sample of Medicare Part B beneficiaries with cataract
who received and did not receive cataract surgery from 2002 through 2009.
MAIN OUTCOME MEASURES: One-year incidence of hip fractures. Analyses were
adjusted for age; sex; race/ethnicity; US region of residence; systemic
comorbidities, including Charlson Comorbidity Index (CCI) score; ocular
comorbidities; cataract severity; and presence of physically limiting conditions.
Adjusted odds ratios (ORs) of hip fractures were calculated using logistic
RESULTS: There were 1 113 640 US Medicare beneficiaries 65 years and older
with a diagnosis of cataract between 2002 and 2009 in the 5% random sample; of
these patients, 410 809 (36.9%) received cataract surgery during the study
period. There were 13 976 patients (1.3%) who sustained a hip fracture during the
study period. The most common fracture-related comorbidity was osteoporosis
(n = 134 335; 12.1%). The most common ocular comorbidity was glaucoma
(n = 212 382; 19.1%). Compared with 1-year hip fracture incidence in patients
with cataract who did not have cataract surgery, adjusted OR of hip fracture
within 1 year after cataract surgery was 0.84 (95% CI, 0.81-0.87) with an
absolute risk difference of 0.20%. Compared with matched subgroups of patients
who did not receive cataract surgery, patient subgroups that experienced lower
odds of hip fracture after cataract surgery included patients with severe
cataract, patients most likely to receive cataract surgery based on propensity
score, patients 75 years and older, and patients with a CCI score of 3 or
CONCLUSION: In a cohort of US Medicare beneficiaries aged 65 years and older
with a diagnosis of cataract, patients who had cataract surgery had lower odds of
hip fracture within 1 year after surgery compared with patients who had not
undergone cataract surgery.
PMID: 23411894 [PubMed – in process]