To the Editor: Dr Owsley and colleagues1 found that adults with cataracts were less likely to be involved in motor vehicle crashes if they underwent cataract surgery. Owsley et al acknowledge that their study was not designed to measure the potential impact of unilateral vs bilateral cataract surgery on risk of motor vehicle crashes. It is possible, however, that having dissimilar vision in the 2 eyes may actually increase the likelihood of crashes. For instance, Felson et al2 found an increased risk of falls and fractures among subjects with good vision in one eye and poor vision in the other.
My colleagues and I have reported 2 studies3 - 4 in which quality of life was measured in persons undergoing cataract surgery in either one or both eyes. Like the study of Owsley et al, these were nonrandomized, observational studies. In both studies, surgery in the second eye was associated with an increase in self-reported visual function. The incremental benefit associated with surgery in the second eye was approximately 50% as great as that associated with surgery in the first.
Similarly, in a randomized, prospective trial, Laidlaw et al5 found significantly more self-reported visual difficulties in subjects who underwent unilateral vs bilateral cataract surgery. The most profound difference was in depth perception. While formal studies in a driving simulator would be required to establish a connection between depth perception and driving ability, this degree of impaired depth perception is likely to affect a driver's ability to judge the relationship of a moving vehicle to both moving and stationary objects. Therefore, while Owsley et al cannot make a definitive statement about unilateral vs bilateral cataract surgery, the accumulated body of literature suggests that surgery in both eyes of patients who have bilateral cataract is the more prudent approach to decreasing the risk of motor vehicle crashes. In fact, a randomized trial to prove this might be dangerous not only to control group subjects, but also to those who share the roads with them.
Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature
Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal
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