Phacoemulsification does not induce neovascular age-related macular degeneration.
OBJECTIVE
To investigate whether cataract surgery by phacoemulsification induces progression of early age-related macular degeneration (AMD) to neovascular AMD.


METHODS
Retrospective case-control study. Included were consecutive patients who had undergone phacoemulsification from January 2000 to February 2006 at the Recklinghausen Eye Centre, who had a preexisting diagnosis of early AMD and who were followed up for at least 1 year after surgery (n = 1152 eyes of 696 patients). The control group comprised phakic patients diagnosed with early AMD from January 2000 to February 2006, who did not undergo eye surgery and were followed up for at least 1 year (n = 334 eyes of 202 patients).


RESULTS
At baseline, control eyes had significantly better visual acuity than those of patients who were going to have cataract surgery (0.30/0.35 +/- 0.34 vs. 0.40/0.49 +/- 0.34, respectively; median/mean +/- SD; P < 0.001, Mann-Whitney rank sum test). After 1 year, visual acuity in the control group was worse than in surgical eyes (0.30/0.39 +/- 0.38 vs. 0.20/0.26 +/- 0.30, respectively; median/mean +/- SD; P < 0.001, Mann-Whitney rank sum test). In the cataract surgery group, neovascular AMD developed in 28 (2.43%) of 1152 eyes in the first postoperative year. In the control group, it developed in 6 (1.74%) of 344 eyes within 1 year. There was no significant difference between the groups in the incidence of neovascular AMD (P = 0.57, odds ratio 1.30, 95% CI 0.52-3.24, logistic regression analysis, adjusted for age and baseline visual acuity).


CONCLUSIONS
The results indicate that cataract surgery in eyes with early AMD is not a causative factor in neovascular AMD.
Baatz
Holger
H
Recklinghausen Eye Centre, Recklinghausen, Germany. holger.baatz@augenzentrum.org
Darawsha
Raed
R
Ackermann
Hanns
H
Scharioth
Gábor B
GB
de Ortueta
Diego
D
Pavlidis
Mitrofanis
M
Hattenbach
Lars O
LO
D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D020256:Choroidal Neovascularization / Q000209:etiology*; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D019654:Lens Implantation, Intraocular; D008268:Macular Degeneration / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification / Q000009:adverse effects*; D012189:Retrospective Studies; D012307:Risk Factors; D014792:Visual Acuity