Cataract Surgery and AMD

In the Oct 31, 2005 blog, I stated that results from the Age-Related Eye Disease Study (AREDS) indicated that cataract surgery did not influence the course of AMD. Despite this report, there have been other smaller studies showing a possible link between cataract surgery and worsening of AMD. Specifically there was a concern that cataract surgery may hasten the onset of the wet form of AMD. The problem with all of the articles that showed a link is that the maculae of patients who had cataract surgery were not carefully examined prior to the surgery. Therefore these patients may already have had AMD, even subtle wet AMD, when they went to the doctor and complained about visual loss. The doctor thought the vision loss was due to the cataract and removed it only to find wet AMD that became obvious a few months later.

A recent article from Germany followed 696 patients who had early AMD for at least one year after cataract surgery. They compared that group to 202 patients with early AMD who didn’t have cataract surgery. After one year, wet AMD developed in 2.43% of the group who had cataract surgery and in 1.74% of the group who did not. There was no significant difference between the groups. There was a statistical difference in the visual acuity however. The group that had cataract surgery had better acuity on average than the group that did not, probably because there was no longer a cataract causing any vision loss.

This is a good article. When coupled with the AREDS results, I think it means that it’s safe for anyone with AMD to have cataract surgery when necessary. The surgery should not be delayed for fear of increasing the risk of wet AMD or vision loss.

Baatz H, Darawsha R, Ackermann H, Scharioth GB, de Ortueta D, Pavlidis M,
Hattenbach LO. Phacoemulsification does not induce neovascular age-related macular degeneration. Invest Ophthalmol Vis Sci. 2008 Mar;49(3):1079-83.