The visual debilitation brought on by cataract development has been linked to depression, and the authors of a recent study wanted to dive deeper and investigate the effect of surgery on the need for medical interventions to alleviate psychological distress. A team from Taiwan assessed usage of mental health consults for depression and anxiety associated with both first- and second-eye surgeries, and sought to determine whether the time interval between procedures affects outcomes of psychological treatment.

A national database of claims was the basis of a cohort study spanning 10 years on 585,422 patients who received cataract surgeries for both eyes. The rates of mental health inpatient and outpatient consultations were analyzed with different time intervals between surgeries (less than three months, three to six months, six to 12 months and more than 12 months).

With patients who had previously sought mental health treatment before their first eye surgery, the number of mental health care consultations decreased postoperatively. This study also found that the decrease in number of mental health consults was less pronounced in patients who had not yet received second-eye surgery and those who received their second procedure more than three months after their first.

The number of mental health consultations was lowest among patients with a time interval of three months or less. For patients with an interval of more than 12 months, the predicted number of mental health consultations increased.

“In our results, mental health care utilization was most reduced in the group with time intervals of less than three months, suggesting that for patients more active in seeking medical help, the benefits of cataract surgery for reducing mental health care consultations are notable,” the authors noted in their paper. “A plausible explanation for our results is that the effects of the surgeries for both eyes are compounded when surgeries are received within a short time interval. For patients with longer time intervals, benefits may be obtained only from surgery on the first eye. Thus, patients with longer time intervals continue to have various degrees of visual dysfunction resulting from the unoperated cataract of the second eye.”


The authors also note there were some limitations of this study. For example, increases in the number of health consultations are not necessarily equivalent to a greater severity of clinical mental illness. “Although considering the actual number of mental health service consultations has merits, future studies should analyze the frequency of mental health consultations in combination with the actual mental health severity on a single study population,” the authors concluded.

Hou C, Chen K, Lee J, et al. Effect of the time interval between cataract surgery for both eyes on mental health outcome: a cohort study of 585,422 patients. BMC Ophthalmol 2021.doi: 10.1186/s12886-021-01876-9