The standard gamble between cataract extraction and AMD

Jong, Paulus T. V. M. de; Lubsen, Jacobus

doi:10.1007/s00417-003-0833-3

Cited by 14 publications

(9 citation statements)

References 20 publications

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“…Findings from large epidemiological studies29,30 of the increased risk of advanced AMD after cataract surgery have led some investigators to speculate that cataract surgery in patients with AMD is a “gamble” for both the patient and the surgeon 31. Other investigators have called for more “stringent” indications for cataract surgery in patients with AMD 30.…”

Section: Discussionmentioning

confidence: 99%

Visual Acuity Outcomes after Cataract Surgery in Patients with Age-Related Macular Degeneration: Age-Related Eye Disease Study Report No. 27

et al. 2009

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Objective-To evaluate visual acuity outcomes after cataract surgery in patients with varying degrees of age-related macular degeneration (AMD). Design-Cohort study.Participants-A total of 4757 participants enrolled in the Age-Related Eye Disease Study (AREDS), a prospective, multicenter, epidemiological study of the clinical course of cataract and AMD and a randomized controlled trial of antioxidants and minerals.Methods-Standardized lens and fundus photographs, performed at baseline and annual visits, were graded by a centralized reading center using standardized protocols for severity of AMD and lens opacities. History of cataract surgery was obtained every 6 months. Analyses were conducted using multivariate logistic regression.Main Outcome Measure-The change in best-corrected visual acuity (BCVA) after cataract surgery compared with preoperative BCVA.Results-Visual acuity results were analyzed for 1939 eyes that had cataract surgery during AREDS. The mean time from cataract surgery to measurement of postoperative BCVA was 6.9 months. After adjustment for age at surgery, gender, type, and severity of cataract, the mean change in visual acuity at the next study visit after the cataract surgery was as follows: Eyes without AMD gained 8.4 letters of acuity (P<0.0001), eyes with mild AMD gained 6.1 letters of visual acuity (P<0.0001), eyes with moderate AMD gained 3.9 letters (P<0.0001), and eyes with advanced AMD gained 1.9 letters (P = 0.04). The statistically significant gain in visual acuity after cataract surgery was maintained an average of 1.4 years after cataract surgery. population have led to a steady increase in cataract surgery rates in the United States during the past 2 decades. 2-4 Both initial and fellow-eye cataract surgery have been demonstrated to be highly cost-effective compared with procedures across multiple medical specialties. 5,6 The benefit of cataract surgery in the general population with respect to visual acuity and visual function has been established. 7,8 Cataract and age-related macular degeneration (AMD) often present concurrently in older persons. [9][10][11] The presence of AMD has been highlighted as an important risk factor for poor visual outcome after cataract surgery. [12][13][14] Given the expected increase in AMD prevalence during the next 2 decades, 15 an analysis of the potential risks and benefits of cataract surgery in patients with AMD is of public health interest. Conclusions-OnSeveral studies have examined the potential benefit of cataract surgery with respect to visual acuity and visual function in patients with AMD. [16][17][18][19][20][21][22] However, prior studies have been limited by the lack of a standardized grading system for AMD and cataract, inclusion of patients with other ocular comorbidities, small sample sizes, and lack of manifest refracted visual acuities before and after cataract surgery. [16][17][18][19]21 Furthermore, in previous studies persons with advanced AMD were underrepresented in the cohort 16,20,21 or not included. 19,22The Age...

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Section: Discussionmentioning

confidence: 99%

Visual Acuity Outcomes after Cataract Surgery in Patients with Age-Related Macular Degeneration: Age-Related Eye Disease Study Report No. 27

et al. 2009

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“…4,5 Recently, serious concerns have been raised about whether cataract surgery may cause or trigger late-stage AMD. 6 Various pathophysiological mechanisms have been discussed to explain a possible positive correlation between cataract surgery and late-stage AMD, including light toxicity during the operation, 7 surgical trauma, or inflammatory factors after surgery, 8 and increased light exposure after removal of the crystalline lens. 9 Several large epidemiologic studies report some degree of positive association of lens opacities, cataract, or cataract surgery with AMD.…”

Section: Discussionmentioning

confidence: 99%

“…10 -13 Such a causative relationship would have widespread clinical, economic, and possibly legal implications. Cataract surgery would become a "gamble" 6 for surgeons and patients alike. In the present study, we investigated the possible relationship of pseudophakia and neovascular AMD, in a retrospective case-control study.…”

Section: Discussionmentioning

confidence: 99%

Is Pseudophakia a Risk Factor for Neovascular Age-Related Macular Degeneration?

Sutter

Menghini

Barthelmes

et al. 2007

Invest. Ophthalmol. Vis. Sci.

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“…The list of risk factors for the development and progression of AMD includes smoking, genetic factors such as an association with the complement factor H gene complex, family history, and ethnic background [6][7][8][9][10][11][12][13][14][15][16][17][18][19]. There has been controversy whether cataract, cataract progression, and cataract surgery are related to AMD [20][21][22][23][24][25][26][27][28][29]. Since interdependencies of ocular parameters with systemic parameters can lead to a bias in the results, it was the purpose of our study to examine whether, in an intra-individual inter-eye comparison, intereye differences in cataract are correlated with inter-eye differences in the amount of AMD.…”

Section: Introductionmentioning

confidence: 99%

Association between asymmetry in cataract and asymmetry in age-related macular degeneration. The Beijing Eye Study

You

Cui

et al. 2010

Graefes Arch Clin Exp Ophthalmol

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In an intra-individual, inter-eye comparison, avoiding interdependencies of systemic parameters, inter-eye difference was not significantly associated with any characteristics of age-related macular degeneration in either any type of cataract or in pseudophakia. This suggests that the development of cataract or cataract surgery did not markedly influence the development of age-related macular degeneration.

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The standard gamble between cataract extraction and AMD

Cited by 14 publications

References 20 publications

Visual Acuity Outcomes after Cataract Surgery in Patients with Age-Related Macular Degeneration: Age-Related Eye Disease Study Report No. 27

Visual Acuity Outcomes after Cataract Surgery in Patients with Age-Related Macular Degeneration: Age-Related Eye Disease Study Report No. 27

Is Pseudophakia a Risk Factor for Neovascular Age-Related Macular Degeneration?

Association between asymmetry in cataract and asymmetry in age-related macular degeneration. The Beijing Eye Study

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