Mortality associated with cataract surgery

Multiple epidemiological studies have shown that cataracts are associated with higher mortality.1^–10 These findings are compatible with the current hypotheses relating oxidative damage and tissue ageing to the development of cataract and other age-related degenerative diseases.11^–13 Nuclear opacity and mixed opacity in particular have been found to be an independent risk factor for mortality, adjusted for health status, frailty and other confounders.8 This relationship was even considered to be causal; that is, the worse the cataract, the higher the mortality. The increased mortality in patients who also underwent cataract surgery continued to be reported by other studies,14^–23 although well-documented progress in phacoemulsification techniques improved surgical safety and efficiency.24

Blundell et al25 have revisited this major concern for the healthcare system in general and ophthalmic personnel in particular, relating to cataract, cataract surgery and mortality (see page 290). As discussed more comprehensively in the paper, there are well-documented reports from across the globe, indicating the higher mortality among cataract subjects. Interestingly, a recent study from China has reiterated that cataract in elderly subjects, is associated with an increased mortality risk.26 It is in this perspective that the current paper attains significance; the speculation that newer cataract surgery techniques have resulted in an overall improvement in the quality of life, leading to decreased mortality. This proposition is attractive, highly desirable and, if in …