Department of Ophthalmology and Optometry, Medical University of Innsbruck, Innsbruck, Austria.
Department of Cranio-Maxillofacial and Oral Surgery, Medical University of Innsbruck, Innsbruck, Austria.
Acta Ophthalmol. 2021 Nov;99(7):e1013-e1017. doi: 10.1111/aos.14748. Epub 2021 Jun 2.
To determine brake reaction times before and after bilateral cataract surgery in elderly drivers.
Sixty-four patients were evaluated on the day of and 4 weeks after bilateral cataract surgery. Forty-three healthy individuals with a valid driving licence served as the control group. A driving simulator was used to determine brake reaction times after receiving a visual stimulus. Total brake reaction time (BRT) as well as neurologic reaction time (NRT), foot transfer time (FTT) and brake pedal travel time (BPTT) were measured, and the measurements obtained before and after cataract surgery were compared. The correlations between NRT, best-corrected visual acuity (BCVA) and contrast sensitivity (CS) were assessed.
Out of the 64 patients with bilateral cataract, 53 were assessed for postsurgical measurements. All time measures improved significantly after cataract surgery (BRT, 815.7(224) versus 647.9(148) ms; NRT, 364.7(91) versus 283.5(44) ms; FTT, 290.8(62) versus 248.6(58) ms; and BPTT, 160.6(96) versus 116.6(72) ms, p < 0.001). The calculated stopping distance improved significantly after surgery (22.3(6) versus 19.9(4) m at 50 km/h). Best-corrected visual acuity (BCVA) and contrast sensitivity (CS) improved significantly after surgery (0.25(0.2) versus 0.05(0.05), n = 53, p < 0.001; 1.4(0.2) versus 1.6(0.1), p < 0.001, respectively). There was a significant negative correlation between CS and NRT before surgery (r = -0.253, n = 64, p = 0.04, Pearson's correlation).
Our findings show a significant effect of CS on neurological BRTs and the corresponding stopping distances. This highlights the importance of presurgical CS evaluation as a critical factor in cataract surgery decisions in elderly drivers.
确定老年驾驶员双侧白内障手术后的制动反应时间。
64 名患者在双侧白内障手术后当天和 4 周后进行评估。43 名具有有效驾驶执照的健康个体作为对照组。使用驾驶模拟器在接收到视觉刺激后确定制动反应时间。测量总制动反应时间（BRT）以及神经反应时间（NRT）、脚部转移时间（FTT）和制动踏板行程时间（BPTT），并比较白内障手术前后的测量值。评估 NRT、最佳矫正视力（BCVA）和对比敏感度（CS）之间的相关性。
在 64 名双侧白内障患者中，有 53 名患者接受了术后测量。所有时间测量值在白内障手术后均显著改善（BRT：815.7(224)与 647.9(148)ms；NRT：364.7(91)与 283.5(44)ms；FTT：290.8(62)与 248.6(58)ms；BPTT：160.6(96)与 116.6(72)ms，p<0.001）。手术后计算出的停车距离显著改善（50km/h 时，22.3(6)与 19.9(4)m）。手术后 BCVA 和 CS 显著改善（0.25(0.2)与 0.05(0.05)，n=53，p<0.001；1.4(0.2)与 1.6(0.1)，p<0.001）。术前 CS 和 NRT 呈显著负相关（r=-0.253，n=64，p=0.04，Pearson 相关）。
我们的研究结果表明 CS 对神经 BRT 和相应的停车距离有显著影响。这突出了术前 CS 评估作为老年驾驶员白内障手术决策中关键因素的重要性。
