Cataract Surgery and the Risk of Aging Macula Disorder: The Rotterdam Study

Abstract

Purpose: : Cataract and aging macula disorder (AMD) are two leading causes of visual impairment in the elderly. It has been suggested that cataract surgery increases the risk of late AMD. In view of the clinical consequences, we investigated whether prior cataract surgery was associated with an increased incidence of AMD in the prospective population-based Rotterdam Study.

Methods: : Associations between baseline lens status and incident AMD (iAMD) were examined in 6032 participants at risk for AMD. We used slit lamp examination to determine lens status and stereoscopic color fundus photography for grading AMD. Odds ratios (ORs) and corresponding 95% confidence intervals (CIs) were estimated with generalized estimating equation (GEE) models.

Results: : After adjusting for age, gender, follow-up time, and the correlation between eyes of the same subject, a history of cataract surgery was associated with incident dry late AMD (OR = 3.43, 95% CI: 1.82; 6.49). This association remained significant after additionally adjusting for smoking status and AMD stage at baseline (OR = 3.44, 95% CI: 1.68; 7.08). No statistically significant association was found between prior cataract surgery and the incidence of wet late AMD or early AMD.

Conclusions: : Our findings suggest that cataract surgery increases the risk of dry AMD. The risk of progression of AMD should be considered before advising cataract surgery to patients with cataract and early AMD.

Keywords: age-related macular degeneration • clinical (human) or epidemiologic studies: risk factor assessment • cataract