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Benjamin Nicholson, Nancy Huynh, Elvira Agrón, Traci Clemons, Emily Chew, ; Visual acuity outcomes after cataract surgery in patients with age-related macular degeneration in the Age-Related Eye Disease Study 2 (AREDS2). Invest. Ophthalmol. Vis. Sci. 2013;54(15):243.
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To evaluate visual acuity outcomes after cataract surgery in patients with varying degrees of age-related macular degeneration (AMD).
A total of 4203 participants with varying degrees of AMD were enrolled in the Age-Related Eye Disease Study 2 (AREDS2), a multicenter, randomized, controlled trial of nutritional supplements for AMD. In assessing secondary outcomes, pre- and post-operative characteristics of participants who underwent cataract extraction during the 5 year trial were analyzed. This analysis was accomplished using both clinical data and standardized lens and fundus photographs obtained at baseline and yearly thereafter. Photographs were graded by a centralized reading center for lens opacities and severity of AMD. Analyses were conducted using multivariate logistic regression.
Visual acuity results were analyzed for 1232 eyes (793 patients) that had cataract surgery during AREDS2. After adjustment for age at cataract surgery, gender, and type and severity of cataract, the mean changes in visual acuity were as follows: eyes with mild AMD (AREDS AMD Scale (AAS) 1-3, n=31) gained 10.7 letters (P<0.0001 when compared to pre-operative acuity), eyes with moderate AMD ((AAS 4-6, n=346) gained 11.2 letters (P<0.0001), eyes with moderate AMD (AAS 7-8, n=464) gained 8.8 letters (P<0.0001), eyes with non-central geographic atrophy (AAS 9, n=70) gained 9.0 letters (P<0.0001), and eyes with advanced AMD (AAS 10-11, n=321) gained 7.0 letters (P<0.0001). The mean time from measurement of pre-operative acuity to cataract surgery was 5.9±3.6 months, and the mean time from surgery to measurement of post-operative acuity was 7.0±3.6 months.
In AREDS2, mean visual acuities improved significantly after cataract surgery across varying severities of AMD.
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