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No Association Between Cataracts and Macular Degeneration Seen in Large Study: Presented at ARVO

By Michael Casasnovas

FT. LAUDERDALE, F.L. -- May 5, 2006 -- No significant association between cataract surgery and neovascular age-related macular degeneration (ARMD) was found in a review of studies on that connection, researchers said here at the Association for Research in Vision and Ophthalmology (ARVO) annual meeting.

"Most patients undergoing cataract surgery can probably be reassured that surgery will not markedly increase their risk for progression to neovascular age-related macular degeneration," said Susan Bressler, MD, director, Wilmer Photograph Reading Center, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland.

Researchers based their investigation on data from the Age-Related Eye Disease Study (AREDS), which explored the possible association between cataract surgery and the neovascular form of advanced age-related macular degeneration. The AREDS study contains a vast collection of cases of advanced age-related macular degeneration and cataract surgery -- far more than the published population-based studies that suggested cataract surgery leads to higher risk of advanced age-related macular degeneration development, Dr. Bressler said.

In their analysis, presented as a poster on May 1^st, Dr. Bressler and colleagues checked outcomes after 1,704 cataract surgeries and 543 neovascular ARMD events after baseline among 8,152 eyes with a median follow-up of 9 years.

The researchers said they were convinced that those figures show no significant association between the events. At 5 years after surgery, the risk of neovascular ARMD was about 10% higher than in the population that did not undergo cataract surgery. There was a 14% increased risk if the cataract was in the right eye, but a 1% decrease in risk if the cataract was in the left eye.

In all of the logistic regression calculations, the confidence interval crossed unity, rendering the conclusion not statistically significant.

Similarly, when the scientists applied a case-control approach to the data they were unable to find a statistically significant relationship between cataract surgery and subsequent neovascular ARMD.

"In this large clinic-based longitudinal cohort study these analyses show no clear evidence of an association between cataract surgery and neovascular age-related macular degeneration," Dr. Bressler said.


[Presentation title: The Effect of Cataract Surgery on the Development of Neovascular Age-Related Macular Degeneration (AMD). Abstract 2175]

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