Cataract surgery delivers no long-term risk of age-related macular degeneration

Cataract surgery is safe and does not confer an increased risk of developing late age-related macular degeneration (AMD) over 10 years of follow-up, according to a study.

The study used data from the Age-Related Eye Disease Study 2 (AREDS2) and included participants aged 50–85 years with either bilateral large drusen or unilateral late AMD.

Researchers compared the incidence of late AMD in eyes that were free of cataract surgery and late AMD at baseline between 1) patients who received cataract surgery after the baseline visit and before any evidence of late AMD and 2) those whose eye/s remained phakic until the study completion. Eyes that had at least 2 years of follow-up after cataract surgery were included in the analysis.

In the cohort, there were 1,767 eligible eyes from 1,195 participants who received cataract surgery and 1,981 eyes from 1,524 participants developed late AMD over a mean follow-up of 9 years. Late AMD was defined as the presence of geographic atrophy or neovascular AMD detected on annual stereoscopic fundus photographs or as documented by medical records, including intravitreous injections of antivascular endothelial growth factor medication.

Cataract surgery showed no association with the risk of developing late AMD across all analyses. In Cox regression models, the hazard ratios (HRs) for late AMD in eyes that received cataract surgery vs phakic controls were 0.96 (95 percent confidence interval [CI], 0.8–1.13; p=0.60) in the right eye and 1.05 (95 percent CI, 0.89–1.25; p=0.56) in the left eye.

In matched-pair and logistic regression analyses, the odds ratio for late AMD was 0.92 (95 percent CI, 0.77–1.10; p=0.34) while the risk ratio was 0.92 (95 percent CI, 0.56–1.49; p=0.73).

The findings provide data for counselling AMD patients who might benefit from cataract surgery.