Does cataract surgery raise the risk of developing late AMD?

A recent study has found that cataract surgery does not contribute to a higher risk of developing late age-related macular degeneration (AMD) among Age-Related Eye Disease Study 2 (AREDS2) participants with up to 10 years of follow-up.

“This study provides data for counseling AMD patients who might benefit from cataract surgery,” the authors said.

AREDS2 participants aged 50 to 85 years with bilateral large drusen or unilateral late AMD were included in this prospective cohort study to assess the risk of developing AMD following incident cataract surgery.

In eyes free of cataract surgery and late AMD at baseline, the authors compared two groups for incident late AMD: eyes that received cataract surgery after the baseline visit and before any evidence of late AMD, and eyes that remained phakic until study completion. Those with at least 2 years of follow-up after the procedure were included in the analysis.

Cox regression models, matched-pair analysis, and logistic regression models were used and adjusted for age, sex, education, smoking, AMD severity, and study treatment group. Late AMD was characterized as the presence of geographic atrophy or neovascular AMD detected on annual stereoscopic fundus photographs or as documented by medical records.

Overall, 1,767 eyes from 1,195 participants underwent cataract surgery. Of these, 1,981 eyes (1,524 participants) developed late AMD during a mean follow-up of 9 years.

In the Cox regression model, the risk of developing late AMD did not increase following cataract surgery (right eye: hazard ratio [HR], 0.96, 95 percent confidence interval [CI], 0.81‒1.13; p=0.60; left eye: HR, 1.05, 95 percent CI, 0.89‒1.25; p=0.56).

Of the matched pairs, 408 eyes that received cataract surgery and 429 phakic controls developed late AMD (odds ratio, 0.92, 95 percent CI, 0.77‒1.10; p=0.34). In the logistic regression model, the risk of late AMD after the procedure did not reach statistical significance (risk ratio, 0.92, 95 percent CI, 0.56‒1.49; p=0.73).