The risk of late AMD is not heightened in patients who undergo cataract surgery. Photo: Amanda Legge, OD. Click image to enlarge.
Ten years ago, results were released from the Age-Related Eye Disease Study (AREDS), which concluded as one of its many findings that cataract surgery was not found to increase the risk of late age-related macular degeneration (AMD). Following its report of this first study, a research team analyzed data from AREDS2, a follow-up of AREDS which included AMD patients in 82 clinics across the United States. The analysis of the updated study detected no increased risk for late AMD in patients who underwent cataract surgery.
Included participants were 50 to 85 years old with bilateral large drusen or unilateral late AMD with up to 10 years of follow-up. As the main purpose of the AREDS studies was to determine the potential of specific nutrient-containing oral supplements, participants were randomly assigned to one of the following: placebo, lutein/zeaxanthin, docosahexaenoic acid, plus eicosapentaenoic acid or a combination. Late AMD was characterized by the presence of geographic atrophy or neovascular AMD observed on fundus photography (or indicated in medical records).
In the AREDS2 study, a total of 1,767 eyes (1,195 participants) received cataract surgery, and 1,981 eyes (1,524 participants) developed late AMD. Researchers found no association between cataract surgery and development of late AMD after performing Cox regression models, a matched-pairs analysis and logistic regression models.
“Of the matched pairs, late AMD was identified in 412 eyes that received cataract surgery and in 433 phakic controls, resulting in an odds ratio of 0.92,” the researchers wrote in their paper. “The risk of late AMD after cataract surgery from the logistic regression model was not statistically significant.”
As the research continues to support, cataract surgery is not shown to increase the risk of late AMD in patients. Presenting clinical data from studies such as this one to patients who are potential candidates for cataract surgery may help to ease any concern.
Bhandari S, Vitale S, Agrón E, et al. The AREDS2 research group, cataract surgery and the risk of developing late age-related macular degeneration: the age-related eye disease study 2 report number 27. Ophthalmology. November 9, 2021. [Epub ahead of print].