Changes in driving performance after first and second eye cataract surgery: A driving simulator study |
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| Institution: | 1. Western Australian Centre for Road Safety Research, School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia;2. Eye & Vision Epidemiology Research (EVER) Group, Perth, Western Australia, Australia;1. School of Transportation, Southeast University, Nanjing 210018, China;2. School of Automobile and Traffic Engineering, Hefei University of Technology, Hefei 230009, China;1. Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institute of Health, 6100 Executive Blvd, Bethesda, MD 20892, United States;2. Virginia Tech Transportation Institute, 3500 Transportation Research Plaza, Blacksburg, VA 24061, United States;1. Road Safety Research Centre, Faculty of Engineering, Universiti Putra Malaysia, 43400 Selangor, Malaysia;2. Civil Engineering Department, Faculty of Engineering, Universiti Pertahanan Nasional Malaysia, 57000 Kuala Lumpur, Malaysia;1. School of Social Sciences, University of Adelaide, South Australia, Australia;2. Institute of Transport Studies, Monash University, Clayton, Victoria, Australia;3. Amy Gillett Foundation, Melbourne, Victoria, Australia;4. Centre for Accident Research and Road Safety – Queensland, Queensland University of Technology (QUT), Queensland, Australia;1. Division of Research, Kaiser Permanente Northern California, Oakland, California;2. Department of Ophthalmology, Kaiser Permanente San Rafael, San Rafael, California;3. Departments of Ophthalmology and Quality, Kaiser Permanente, Walnut Creek, California |
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| 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. |
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| Keywords: | Cataract surgery Driving performance Driving simulator Visual measures |
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