We know that cataract surgery can improve vision, which aids in the performance of patients’ daily activities. Studies have even shown that increased vision improves performance on driving simulators and may improve safety. But can cataract surgery limit cognitive decline that is associated with advanced age? And can cataract surgery actually increase lifespan?
A 2018 study from Maharani and colleagues from the University of Manchester studied 2000 patients who underwent cataract surgery and compared them with a control group. The authors found that “cataract surgery was positively associated with episodic memory scores after controlling for the potential covariates.” They concluded that cataract surgery may have a positive association with age-related cognitive decline.
However, cataract surgery also was associated with a higher risk of mortality according to a large study of women published in JAMA Ophthalmology earlier this year. A total of more than 70 000 patients were analyzed, and the group that had cataract surgery had a higher rate of death during the study period.
It is important to remember that these studies show an association of cataract surgery with the undesirable outcome of a shorter life but with better cognitive function; however, neither of these associations prove a direct cause and effect relationship. Still, we know from personal experience that cataract surgery can be transformative for patients, particularly if the preoperative visual function is substantially impaired.
My fellow cataract surgeons can relate to the pure joy of seeing happy and grateful patients on their first postoperative day. The return of visual clarity, sharp acuity, vivid colors, and improved contrast make an immediate impact on patients’ lives. While I’m not sure that cataract surgery itself improves mental function or shortens life, I know for certain that restoration of vision makes patients, and ophthalmologists, very happy.