Curtin-Monash Accident Research Centre (C-MARC), Curtin University, GPO BOX U1987, PERTH, WA, 6845, Australia.
Eye & Vision Epidemiology Research (EVER) Group, Perth, WA, Australia.
BMC Geriatr. 2018 Feb 17;18(1):51. doi: 10.1186/s12877-018-0743-1.
Driving a car is the most common form of transport among the older population. Common medical conditions such as cataract, increase with age and impact on the ability to drive. To compensate for visual decline, some cataract patients may self-regulate their driving while waiting for cataract surgery. However, little is known about the self-regulation practices of older drivers throughout the cataract surgery process. The aim of this study is to assess the impact of first and second eye cataract surgery on driver self-regulation practices, and to determine which objective measures of vision are associated with driver self-regulation.
Fifty-five older drivers with bilateral cataract aged 55+ years were assessed using the self-reported Driving Habits Questionnaire, the Mini-Mental State Examination and three objective visual measures in the month before cataract surgery, at least one to three months after first eye cataract surgery and at least one month after second eye cataract surgery. Participants' natural driving behaviour in four driving situations was also examined for one week using an in-vehicle monitoring device. Two separate Generalised Estimating Equation logistic models were undertaken to assess the impact of first and second eye cataract surgery on driver-self-regulation status and which changes in visual measures were associated with driver self-regulation status.
The odds of being a self-regulator in at least one driving situation significantly decreased by 70% after first eye cataract surgery (OR: 0.3, 95% CI: 0.1-0.7) and by 90% after second eye surgery (OR: 0.1, 95% CI: 0.1-0.4), compared to before first eye surgery. Improvement in contrast sensitivity after cataract surgery was significantly associated with decreased odds of self-regulation (OR: 0.02, 95% CI: 0.01-0.4).
The findings provide a strong rationale for providing timely first and second eye cataract surgery for older drivers with bilateral cataract, in order to improve their mobility and independence.
开车是老年人最常见的交通方式。随着年龄的增长，白内障等常见疾病会增加，并影响驾驶能力。为了弥补视力下降，一些白内障患者可能会在等待白内障手术的同时自行调节驾驶。然而，对于白内障手术过程中老年司机的自我调节行为知之甚少。本研究旨在评估双眼白内障患者第一只眼和第二只眼白内障手术后对司机自我调节行为的影响，并确定哪些客观视力测量与司机自我调节行为相关。
对 55 名年龄在 55 岁以上的双眼白内障老年司机进行了评估，使用自我报告的驾驶习惯问卷、简易精神状态检查和三种客观视觉测量，分别在白内障手术前一个月、第一只眼白内障手术后至少一至三个月以及第二只眼白内障手术后至少一个月。还使用车载监测设备对参与者在四种驾驶情况下的自然驾驶行为进行了一周的检查。采用广义估计方程逻辑模型分别评估第一只眼和第二只眼白内障手术后对司机自我调节状态的影响，以及视觉测量的哪些变化与司机自我调节状态相关。
与第一只眼白内障手术前相比，第一只眼白内障手术后至少一种驾驶情况下自我调节的可能性显著降低了 70%（OR：0.3，95%CI：0.1-0.7），第二只眼白内障手术后降低了 90%（OR：0.1，95%CI：0.1-0.4）。白内障手术后对比敏感度的改善与自我调节的可能性降低显著相关（OR：0.02，95%CI：0.01-0.4）。
这些发现为及时为双眼白内障老年司机提供第一只眼和第二只眼白内障手术提供了有力的依据，以提高他们的机动性和独立性。
