AAO-sponsored research shows cataract surgery can reduce hip fracture risk

(Press-News.org) SAN FRANCISCO – August 1, 2012 – A major study of Medicare beneficiaries shows that the risk of hip fractures was significantly reduced in patients who had had cataract surgery, compared to patients who did not undergo the procedure. Published in the August edition of the Journal of the American Medical Association (JAMA) the researchers believe their study is the first to demonstrate that cataract surgery reduces the rate of fractures in older patients with vision loss. This suggests that cataract surgery could be an effective intervention to help prevent fractures and reduce associated morbidity and costs. The American Academy of Ophthalmology and the Jules Stein Eye Institute at the University of California, Los Angeles, collaborated on the study.

The study tracked hip fracture incidence in a cohort of Medicare patients with cataracts from 2002-09. Anne L. Coleman, M.D., Ph.D., the Fran and Ray Stark professor of ophthalmology at the Jules Stein Eye Institute at UCLA and director of the Academy's Hoskins Center for Quality Eye Care, led the research. The medical records of about 400,000 patients who had cataract surgery were analyzed for hip fractures that occurred within one year of cataract surgery. This data was then compared to hip fracture incidence in a matched group of patients who had cataracts, but did not have cataract surgery. Cataract surgery was associated with a 16 percent decrease in patients' adjusted odds of suffering a hip fracture within one year of the procedure.

This is particularly significant because older people's higher risk of falling makes them especially vulnerable to fractures of the hip and other bones. Previous studies have found that vision loss is a major factor in seniors' risk of falling. When visual sharpness and depth perception decline, people also lose their ability to maintain balance, stability and mobility.

"Our study suggests that people should never be regarded as 'too old' to have their cataracts removed," said Dr. Coleman, who also serves as the Academy's secretary for quality of care. "In fact, the greatest reduction in hip fracture risk was in patients who had cataract surgery when they were in their 80s."

Overall, the greatest decrease in hip fracture risk was seen in patients aged 80 to 84 who had cataract surgery. Another notable group was patients with severe cataracts, for whom risk was reduced by 23 percent. Although U.S. health statistics show that women are more susceptible to hip fractures than men, this study found no significant gender-linked differences in fracture risk.

"When older people's vision improves following cataract surgery, they, their families, and society gain from the resulting reductions in suffering and medical costs," said William L. Rich, M.D., a cataract specialist and the Academy's medical director for health policy. "Ophthalmic research continues to demonstrate that cataract surgery is highly successful in terms of patient-reported outcomes such as improved vision and quality of life. The new study provides data on an important ancillary health benefit."

###The H. Dunbar Hoskins Jr., M.D. Center for Quality Eye Care, a program of the Academy, obtained the Medicare database for the study and collaborated on analysis and interpretation. Flora C. Lum, M.D., who serves as executive director of the Hoskins Center, is a co-author in the study.

Note to media: Contact the Academy's Media Relations Department to arrange interviews with study leaders.

About the American Academy of Ophthalmology The American Academy of Ophthalmology is the world's largest association of eye physicians and surgeons — Eye M.D.s — with more than 32,000 members worldwide. Eye health care is provided by the three "O's" – ophthalmologists, optometrists, and opticians. It is the ophthalmologist, or Eye M.D., who can treat it all: eye diseases, infections and injuries, and perform eye surgery. For more information, visit www.aao.org The Academy's EyeSmart® public education program works to educate the public about the importance of eye health and to empower them to preserve their healthy vision, by providing the most trusted and medically accurate information about eye diseases, conditions and injuries. Visit www.geteyesmart.org to learn more.

About The H. Dunbar Hoskins Jr., M.D. Center for Quality Eye Care The H. Dunbar Hoskins Jr., M.D. Center for Quality Eye Care was established as a quality of care and health policy research center that advances the accessibility to and appropriateness of eye care services. The work of the Hoskins Center will help ensure that patients continue to receive high quality, evidence-based eye care within a tightening economic environment that will demand increased value for any services provided. For more information, visit http://www.aaofoundation.org/hoskins/index2.cfm.