Risk of advanced age-related macular degeneration after cataract surgery in the Age-Related Eye Disease Study: AREDS report 25.
OBJECTIVE
To assess the risk of advanced age-related macular degeneration (AMD) developing after cataract surgery.


METHODS
Cohort study.


METHODS
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.


METHODS
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.


BACKGROUND
The author(s) have no proprietary or commercial interest in any materials discussed in this article.
Chew
Emily Y
EY
National Eye Institute, Bethesda, Maryland, USA.
Sperduto
Robert D
RD
Milton
Roy C
RC
Clemons
Traci E
TE
Gensler
Gary R
GR
Bressler
Susan B
SB
Klein
Ronald
R
Klein
Barbara E K
BE
Ferris
Frederick L
FL
D000368:Aged; D000369:Aged, 80 and over; D000975:Antioxidants / Q000627:therapeutic use; D001284:Atrophy; D002387:Cataract Extraction; D019587:Dietary Supplements; D018450:Disease Progression; D005260:Female; D006801:Humans; D008268:Macular Degeneration / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D016016:Proportional Hazards Models; D011446:Prospective Studies; D055213:Retinal Pigment Epithelium / Q000473:pathology; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014792:Visual Acuity
D000975:Antioxidants