Cataract surgery in seniors Is actually life-extending, new study says

New research suggests that if you undergo cataract surgery, you'll not only see more clearly, you also may actually live longer.

A National Bureau of Economic Research study says Americans over 65 are living longer and with fewer disabilities, and that a chief reason is cataract surgery, which prevents falls and allows seniors to continue working and driving safely.

Those who have cataract surgery are less likely to experience disability than people who don't, according to the June NBER paper. Between 1992 and 2008, healthy life expectancy at age 65 increased by 1.8 years, the study says, and two treatments contributed: better cardiac care and cataract surgery.

Those who opt for cataract surgery also lower their odds of breaking a hip. In a group of Medicare beneficiaries 65 and older with a diagnosis of cataracts, patients who had surgery to remove them had lower odds of hip fracture within one year compared with patients who had not undergone cataract surgery, according to a 2012 JAMA article.

Another study, for the American Academy of Ophthalmology, showed some of the financial benefits of cataract surgery.

The cost is going down, for one thing: in 2012, the surgery cost 34 percent less than in 2000, and 85 percent less than in 1985. The net 13-year $123.4 billion financial return-on-investment from a one-year cohort of cataract-surgery patients totaled savings to Medicare of $36.4 billion; to Medicaid, $3.3 billion; and to other insurers, $9.6 billion, this study showed.

Savings to patients totaled $48.6 billion, the study said, valuing the increased U.S. national productivity that resulted at $25.4 billion.

With a cataract, the lens of the eye becomes progressively opaque, which can significantly interfere with vision - as Jeanne Walker, a poet and professor of English at the University of Delaware, learned.

One evening, Walker said, she drove to take dinner to a friend who was recovering from a heart problem. "It was sundown when I drove back, and I couldn't see the street signs and didn't know where I was," she recalled. "I realized that I couldn't do that again."

Walker commutes by car from Merion a few times a week to the Newark, Del., campus and had never missed more than a week or two of work. "How was I going to keep my life together?" she wondered.

Diagnosed with cataracts in both eyes, she spaced out her two surgeries at Wills Eye Hospital over several months. Since the surgery, she said, "I can see a bird land on Billy Penn's hat when I'm standing down on Market Street. I see in a way I could never see before. That's not minimum wellness - that is a new kind of pleasure of the sort that when you go to the museum, you stand at the door and see everything in the room. I have 20/20 vision or pretty close to it. Having that is life-extending - how could it be otherwise?"

Lisa Hark, a PhD. who is director of Wills Eye's Department of Research, is working to combat myths regarding cataract surgery, particularly among the elderly and minorities.  "There's an old fear of going blind from cataract surgery, even though it is so technologically advanced now," she said, using pain-free lasers and procedures that last just a few hours. Patients go home the same day.

Many Philadelphia-area seniors don't get annual eye exams and don't realize they're losing vision, she said: "Many are already legally blind, but don't know it because the brain adapts. When you slowly lose peripheral vision, due to glaucoma or cataracts, your brain accommodates" and tries to fix the field of vision.

So "you can really only detect cataracts with an eye exam," Hark said. Broadcasting that message to Philadelphians - particularly African Americans, who are eight times more likely to have glaucoma - is her main goal.

Walker, who makes a living by writing poetry and teaching, couldn’t work, couldn’t write, could barely read.  As she went in for cataract surgery, her friend and fellow poet Deborah Burnham, wrote this to the doctor:

Little Prayer  for the Surgeon

That his hands will move clean as an icy stream — deliberate and joyous/ That his hands will hold slim blades as softly as we touch a blossom/That he too will pray for steadiness/He knows the words by heart, by hand, by now/Ah, steadiness: the secret joy of rocks, of old, old love.

After the operation, Walker gave the poem to Stephen Lichtenstein, her surgeon at Wills Eye.  

"He glanced down and read it. Then he brushed his eyes, and quickly left the room," she said. "When he returned, he said he had put the poem up in his office. We went on to talk about more practical things like recovery after cataract surgery."

Mostly, Walker said, "I am grateful for the astonishing gift of a surgeon’s steady hands, the gift of light we elders enjoy in this country — which many people in other countries don’t."

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