Posted , 5 users are following.
It's my fault for not considering this before my surgeries, but is any sort of offset between the eyes contraindicated in people with osteoporosis?
0 likes, 16 replies
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jo61855 judith93585
Posted
The surgeon should take into consideration a person's age and health history when recommending alternatives. Did yours caution you about your preference for near monovision?
judith93585 jo61855
Posted
No, no one did ...
maura04015 judith93585
Posted
Don't you have two monofocals? If you think what you have is causing balance problems, why not get glasses and remedy that? I really doubt most of us are thrown off as much as you have been by the difference between your eyes. I have that much naturally and go around the house without any corrective lenses all the time (I'm 78). We're all different. Just people reporting here how close they can see with monofocal lenses set for distance shows a considerable spread.
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My doctor, now retired, used to tell me all the time, "If you want to have a good old age, don't fall." He further recommended making sure to have 3 support points, which means not relying on legs alone but having places to grip or using a cane, etc. I know I'd never do what RonAKA mentioned doing in another thread, that is, standing on a stool for height, at least not unless it was close enough to a wall or something else I could hold on to with one hand. My balance isn't that good any more, and while I resent the necessity, needs must as they say.
judith93585
Edited
Yes, both IOLs are monofocals. In case it matters, my IOLs are not set for distance. This is near bias. My appointments for a 6 week check by my surgeon and refraction by my optometrist are at the end of January. One of my questions relates to how long after implantation can an IOL be replaced. Appts are very tight and I haven't been able to reschedule.
RonAKA judith93585
Edited
I cannot for the life of me think of any way that osteoporosis and cataract surgery could have any interaction. They are both age related though. I recall that the most common cause of falls in the elderly is the use of prescription sleeping pills.
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There was another study that found that people with mini-monovision had a lower rate of falling compared to people with cataract pre surgery, and to those who got IOLs set for distance after surgery.
jo61855 RonAKA
Edited
That study, as pointed out to you, had an age of subjects gross imbalance with older people in the distance vision group and only 1.8% in the monovision group. I have a background in statistics and research methodology.
judith93585 RonAKA
Posted
Thanks Ron. I don't mean to be critical of monovision in general. I do have a problem however and hope to receive feedback regarding my specific questions.
ka76787 jo61855
Edited
Is this the study, "Fall risk in patients with pseudophakic monovision
Tatiana R Rosenblatt et al. Can J Ophthalmol. 2023 Feb."? They state, "Pseudophakic monovision was not associated with fall risk after controlling for age, sex, and myopia."
RonAKA jo61855
Posted
"A total of 13,385 patients were included in the study, of which 1.8% had pseudophakic monovision, 21% had pseudophakic single vision and 77.2% had not undergone surgery. When the researchers looked at the documented falls after cataract diagnosis, they found that pseudophakic single-vision patients had the highest fall rate of 7.9%, followed by no-surgery patients (5.9%) and pseudophakic monovision patients (5.8%). The overall rate of falls post-cataract diagnosis was 6.4%.
After being adjusted for age, sex and preexisting myopia, the data revealed no impact of pseudophakic monovision on fall risk in elderly patients. However, the pseudophakic single-vision group may face a disadvantage over the no-surgery group that explains the increased fall risk."
The 1.8% was the % of total subjects that had monovision, not that they were younger. 1.8% of 13,385 is still 241 subjects which is not an insignificant number. And the conclusions were adjusted for age. I think the study is still valid in concluding that monovision does not elevate fall risk, but in fact lowers it.
RonAKA judith93585
Posted
Your experience would not be critical of monovision, as you really do not have monovision. I hope you get to the bottom of your issue, but I think you are going down a dead end road blaming the small imbalance between the eyes.
jo61855 RonAKA
Posted
Copied from Study Link:
"Methods: Data were obtained from the Stanford Research Repository. Time-to-fall analysis was performed across all 3 groups. Primary outcome was hazard ratio (HR) for fall after second eye cataract surgery or after bilateral cataract diagnosis.
Results: Of 13 385 patients (241 pseudophakic monovision, 2809 pseudophakic single vision, 10 335 no surgery), 850 fell after cataract diagnosis. Pseudophakic monovision was not associated with fall risk after controlling for age, sex, and myopia. Pseudophakic single-vision patients had a decreased time to fall compared with no-surgery patients (log rank, p < 0.001).*** Older age at cataract diagnosis (HR =1.05, 95% confidence interval [CI] 1.04-1.06, p < 0.001) or at time of surgery (HR = 1.05, 95% CI 1.03-1.07, p < 0.001) increased fall risk, as did female sex (HR = 1.29, 95% CI 1.10-1.51, p = 0.002) and preexisting myopia (HR = 1.31, 95% CI 1.01-1.71, p = 0.046) among nonsurgical patients.*
Conclusions: Pseudophakic monovision did not impact fall risk, but pseudophakic single vision may increase falls compared with patients without cataract surgery."
jo61855
Edited
"Pseudophakic single-vision patients had a decreased time to fall compared with no-surgery patients (log rank, p < 0.001).*** Older age at cataract diagnosis (HR =1.05, 95% confidence interval [CI] 1.04-1.06, p < 0.001) or at time of surgery (HR = 1.05, 95% CI 1.03-1.07, p < 0.001) increased fall risk, as did female sex (HR = 1.29, 95% CI 1.10-1.51, p = 0.002) and preexisting myopia (HR = 1.31, 95% CI 1.01-1.71, p = 0.046) among nonsurgical patients."
Factors that increased fall risk - recopied from above for emphasis
RonAKA jo61855
Posted
But cutting to the chase:
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"After being adjusted for age, sex and preexisting myopia, the data revealed no impact of pseudophakic monovision on fall risk in elderly patients."
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It would not be reasonable to blame monovision for increased risk of falling.
jo61855 RonAKA
Posted
Study concludes monovision does not elevate fall risk, but study does not conclude that it lowers fall risk.
They did identify certain risk factors that would most likely apply to all subjects in three way paired subject design.
RonAKA jo61855
Posted
That was not my interpretation of the study conclusions. And for sure it did not provide any support of the theory that monovision increases risk of falling, which is the subject of this thread.