Phaco does not boost AMD progression

No clear link between cataract surgery and progressive age-related macular degeneration (AMD) could be established by a study published in the February issue of Ophthalmology.

Emily Y. Chew of the US National Eye Institute, Bethesda, Maryland and colleagues assessed the incidence of advanced AMD development among participants in the Age-Related Eye Disease Study (AREDS). Participants (n=4577; eyes, n=8050) - aged 55–80 years, with a visual acuity of 20/32 or better at baseline - were assessed for geographic atrophy, geographic atrophy of the central macula and neovascular AMD, and a history of cataract surgery was taken at six month intervals for up to 11 years. One thousand, one hundred and sixty-seven participants underwent cataract surgery during the study period.

The Cox proportional hazards model for right and left eyes showed no significant increase of risk for AMD after phacoemulsification. In the right eye, the hazard ratio for geographic atrophy, central geographic atrophy and neovascular AMD were 0.80, 0.87 and 1.20, respectively; in the left eye, these ratios were 0.94, 0.86 and 1.07, respectively. In eyes with pre-existing advanced AMD, the hazard ratios for the fellow eye were 0.98 for central geographic atrophy and 1.08 for neovascular AMD.

Contrary to previous study results, therefore, the team concluded that cataract surgery did not increase the risk of AMD progression significantly.