FEB 27, 2009
Researchers analyzed the severity of AMD before and after cataract surgery among the 4577 participants (8050 eyes) in the Age-Related Eye Disease Study (AREDS), who had varying degrees of AMD and were followed up every six months for up to 11 years. Using the Cox regression model, they examined the effect of time-dependent covariates on progression to late AMD. They found no clinically important increased risk of progression to advanced AMD after cataract surgery.
This is a huge relief. We can continue to counsel our patients that their risk is the same as everyone else having cataract surgery. What will be, will be with regard to their macular degeneration whether the cataract is removed or not.
The remaining challenge: to assess in each individual the contribution of the cataract compared to the impact of macular dysfunction on visual disability - at any point in time - to determine whether the low statistical risk of complications is outweighed by the benefit of clearing the visual axis. This does not negate the benefit of confirming the absence of subretinal neovascularization, which deserves treatment prior to surgery, to avoid the attendant pressure variation causing oozing or bleeding of pre-existing vessels.