title: Visual acuity after cataract surgery in patients with age-related macular degeneration: age-related eye disease study 2 report number 5.
abstract: OBJECTIVE
  To evaluate visual acuity outcomes after cataract surgery in persons with varying degrees of severity of age-related macular degeneration (AMD).
  
  
  METHODS
  Cohort study.
  
  
  METHODS
  A total of 1232 eyes of 793 participants who underwent cataract surgery during the Age-Related Eye Disease Study 2, a prospective, multicenter, randomized controlled trial of nutritional supplements for treatment of AMD.
  
  
  METHODS
  Preoperative and postoperative characteristics of participants who underwent cataract extraction during the 5-year trial were analyzed. Both clinical data and standardized red-reflex lens and fundus photographs were obtained at baseline and annually. Photographs were graded by a centralized reading center for cortical and posterior subcapsular lens opacities and for AMD severity. Cataract surgery was documented at annual study visits or by history during the 6-month telephone calls. Analyses were conducted using multivariate repeated-measures regression.
  
  
  METHODS
  Change in best-corrected visual acuity (BCVA) after cataract surgery compared with preoperative BCVA.
  
  
  RESULTS
  Adjusting for age at time of surgery, gender, interval between preoperative and postoperative visits, and type and severity of cataract, the mean changes in visual acuity were as follows: eyes with mild AMD (n = 30) gained 11.2 letters (95% confidence interval [CI], 6.9-15.5), eyes with moderate AMD (n = 346) gained 11.1 letters (95% CI, 9.1-13.2), eyes with severe AMD (n = 462) gained 8.7 letters (95% CI, 6.7-10.7), eyes with noncentral geographic atrophy (n = 70) gained 8.9 letters (95% CI, 5.8-12.1), and eyes with advanced AMD (central geographic atrophy, neovascular disease, or both; n = 324) gained 6.8 letters (95% CI, 4.9-8.8). The visual acuity gain across all AMD severity groups was statistically significant from preoperative values (P < 0.0001).
  
  
  CONCLUSIONS
  Mean visual acuities improved significantly after cataract surgery across varying degrees of AMD severity.
authors.affiliation: Clinical Trials Branch, Division of Epidemiology and Clinical Applications, National Eye Institute, National Institutes of Health, Bethesda, Maryland.
authors.forename: Nancy
authors.initials: N
authors.lastname: Huynh
authors.affiliation: Clinical Trials Branch, Division of Epidemiology and Clinical Applications, National Eye Institute, National Institutes of Health, Bethesda, Maryland.
authors.forename: Benjamin P
authors.initials: BP
authors.lastname: Nicholson
authors.affiliation: Clinical Trials Branch, Division of Epidemiology and Clinical Applications, National Eye Institute, National Institutes of Health, Bethesda, Maryland.
authors.forename: Elvira
authors.initials: E
authors.lastname: Agrón
authors.affiliation: EMMES Corporation, Rockville, Maryland.
authors.forename: Traci E
authors.initials: TE
authors.lastname: Clemons
authors.affiliation: Wilmer Eye Institute, The Johns Hopkins University School of Medicine, Baltimore, Maryland.
authors.forename: Susan B
authors.initials: SB
authors.lastname: Bressler
authors.affiliation: Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida.
authors.forename: Philip J
authors.initials: PJ
authors.lastname: Rosenfeld
authors.affiliation: Clinical Trials Branch, Division of Epidemiology and Clinical Applications, National Eye Institute, National Institutes of Health, Bethesda, Maryland. Electronic address: echew@nei.nih.gov.
authors.forename: Emily Y
authors.initials: EY
authors.lastname: Chew
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002386:Cataract / Q000503:physiopathology; D015331:Cohort Studies; D019587:Dietary Supplements; D015525:Fatty Acids, Omega-3 / Q000008:administration & dosage; D005260:Female; D006801:Humans; D019654:Lens Implantation, Intraocular; D014975:Lutein / Q000008:administration & dosage; D008268:Macular Degeneration / Q000145:classification / Q000188:drug therapy / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification; D011446:Prospective Studies; D019591:Pseudophakia / Q000503:physiopathology*; D012720:Severity of Illness Index; D014792:Visual Acuity / Q000502:physiology*; D014815:Vitamins / Q000008:administration & dosage; D024341:Xanthophylls / Q000008:administration & dosage; D065146:Zeaxanthins
chemical_list: D015525:Fatty Acids, Omega-3; D014815:Vitamins; D024341:Xanthophylls; D065146:Zeaxanthins; D014975:Lutein