Risk of advanced age-related macular degeneration after cataract surgery in the Age-Related Eye Disease Study: AREDS report 25.

Publication Type
Journal Article
Year of Publication
Chew, Emily Y; Sperduto, Robert D; Milton, Roy C; Clemons, Traci E; Gensler, Gary R; Bressler, Susan B; Klein, Ronald; Klein, Barbara E K; Ferris, Frederick L
Date Published
2009 Feb
Aged; Aged, 80 and over; Antioxidants; Atrophy; Cataract Extraction; Dietary Supplements; Disease Progression; Female; Humans; Macular Degeneration; Male; Middle Aged; Postoperative Complications; Proportional Hazards Models; Prospective Studies; Retinal Pigment Epithelium; Risk Factors; Surveys and Questionnaires; visual acuity

PURPOSE: To assess the risk of advanced age-related macular degeneration (AMD) developing after cataract surgery.

DESIGN: Cohort study.

PARTICIPANTS: Four thousand five hundred seventy-seven participants (8050 eyes) from a multicenter, controlled, randomized clinical trial, the Age-Related Eye Disease Study (AREDS).

METHODS: Development of advanced AMD, either neovascular (NV) AMD or geographic atrophy (GA), was evaluated with annual fundus photographs, and history of cataract surgery was assessed every 6 months. Cox proportional hazard models with time-dependent covariates were conducted for NV AMD and GA separately.

MAIN OUTCOME MEASURES: Neovascular AMD, GA, and central GA (CGA; involving the center of the macula).

RESULTS: The Cox proportional hazards model of right eyes showed nonsignificant hazard ratios of 1.20 (95% confidence interval [CI], 0.82-1.75) for NV AMD, 0.80 (95% CI, 0.61-1.06) for GA, and 0.87 (95% CI, 0.64-1.18) for CGA. Similar results were obtained for left eyes: 1.07 (95% CI, 0.72-1.58) for NV AMD, 0.94 (95% CI, 0.71-1.25) for GA, and 0.86 (95% CI, 0.63-1.19) for CGA. For participants with advanced AMD in 1 eye (AREDS category 4), the hazard ratios for fellow eyes were 1.08 (95% CI, 0.65-1.72) for NV AMD and 0.98 (95% CI, 0.64-1.49) for CGA.

CONCLUSIONS: The AREDS results showed no clear effect of cataract surgery on the risk of progression to advanced AMD.

FINANCIAL DISCLOSURE(S): The author(s) have no proprietary or commercial interest in any materials discussed in this article.