People with age-related macular degeneration (AMD) can undergo cataract surgery without fear of worsening their disease, according to the latest analysis of data from the Age-related Eye Disease Study 2 (AREDS2), a clinical trial sponsored by the National Eye Institute (NEI). Data from the analysis were gathered in a 5-year study that tested combinations of dietary supplements for their ability to slow AMD progression. AMD damages the light-sensing tissue in the back of the eye called the retina and is one of the most common causes of vision loss in the U.S. Cataract surgery is a common procedure to treat the clouding of the eye’s lens. NEI is part of the NIH.
“The results of this study will help people with AMD and their care providers more accurately weigh the pros and cons of cataract surgery,” said Emily Chew, M.D., director, NEI Division of Epidemiology and Clinical Applications. “Our results indicate people don’t need to avoid or delay cataract surgery for fear of worsening their AMD.”
Chew and colleagues conducted analyses of a subset of 4,553 AREDS2 participants’ eyes to assess whether cataract surgery increased the risk of progression to late (advanced) AMD. They included only eyes that at the start lacked signs of advanced AMD and had not had cataract surgery. Eyes that later developed cataract and were treated with surgery were compared with similar AREDS2 participants who did not undergo cataract surgery.
The researchers found no increased risk of advanced AMD among participants who underwent cataract surgery, compared with cataract surgery-free eyes. Diagnosis of advanced AMD was determined by a variety of criteria, including retinal changes or treatment for AMD.
“Findings in this study reflect the typical surgical techniques that most U.S. patients receive today,” said Chew. “The standard for removing cataracts, called phacoemulsification, where the lens is broken into tiny pieces, causes less trauma and inflammation than older techniques. This could help explain why past studies saw an association between cataract surgery and progression to advanced AMD and we didn’t.”
Bhandari, S., Vitale, S., Agrón, E., Clemons, T. E. & Chew, E. Y. Cataract Surgery and the Risk of Developing Late Age-Related Macular Degeneration: The Age-Related Eye Disease Study 2 Report Number 27. Ophthalmology, doi:10.1016/j.ophtha.2021.11.014 (2021).
NEI leads the federal government’s research on the visual system and eye diseases. NEI supports basic and clinical science programs to develop sight-saving treatments and address special needs of people with vision loss. For more information, visit https://www.nei.nih.gov.
About the National Institutes of Health (NIH): NIH, the nation’s medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit https://www.nih.gov/.
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Cataract surgery does not cause disease progression in people with AMD
"Cataract surgery did not increase risk of progression to late AMD" - Dr. Emily Chew, National Eye Institute