Risk of Advanced Age-Related Macular Degeneration after Cataract Surgery in the Age-Related Eye Disease Study: AREDS Report No. 25
02/2009
Journal Article
Authors:
Chew, E.;
Sperduto, R.;
Milton, R.;
Clemons, T.;
Gensler, G.;
Bressler, S.;
Klein, R.;
Klein, B.;
Ferris, F.3rd;
Group, A.R.E.D.S.Study
Secondary:
Ophthalmology
Volume:
116
Pagination:
297-303
URL:
http://www.ncbi.nlm.nih.gov/pubmed/19091420
Keywords:
Aged; Antioxidants; Atrophy; Cataract Extraction; Dietary Supplements; Disease Progression; Female; Macular Degeneration; Male; Middle Aged; Postoperative Complications; Proportional Hazards Models; Prospective Studies; Research NIH Extramural
Abstract:
PURPOSE: To assess the risk of advanced age-related macular degeneration (AMD) developing after cataract surgery. DESIGN: Cohort study. PARTICIPANTS: Four thousand five hundred seventy-seven participants (8050 eyes) from a multicenter, controlled, randomized clinical trial, the Age-Related Eye Disease Study (AREDS). METHODS: Development of advanced AMD, either neovascular (NV) AMD or geographic atrophy (GA), was evaluated with annual fundus photographs, and history of cataract surgery was assessed every 6 months. Cox proportional hazard models with time-dependent covariates were conducted for NV AMD and GA separately. MAIN OUTCOME MEASURES: Neovascular AMD, GA, and central GA (CGA; involving the center of the macula). RESULTS: The Cox proportional hazards model of right eyes showed nonsignificant hazard ratios of 1.20 (95% confidence interval [CI], 0.82-1.75) for NV AMD, 0.80 (95% CI, 0.61-1.06) for GA, and 0.87 (95% CI, 0.64-1.18) for CGA. Similar results were obtained for left eyes: 1.07 (95% CI, 0.72-1.58) for NV AMD, 0.94 (95% CI, 0.71-1.25) for GA, and 0.86 (95% CI, 0.63-1.19) for CGA. For participants with advanced AMD in 1 eye (AREDS category 4), the hazard ratios for fellow eyes were 1.08 (95% CI, 0.65-1.72) for NV AMD and 0.98 (95% CI, 0.64-1.49) for CGA. CONCLUSIONS: The AREDS results showed no clear effect of cataract surgery on the risk of progression to advanced AMD.
