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Li Ming Dong, PhD; Walter J. Stark, MD; Joan L. Jefferys, ScM; Selwa Al-Hazzaa, MD; Susan B. Bressler, MD; Sharon D. Solomon, MD; Neil M. Bressler, MD

Arch Ophthalmol. 2009;127(11):1412-1419.

Objective  To document age-related macular degeneration (AMD) progression after cataract surgery.

Methods  Surgeons prospectively enrolled patients with nonneovascular AMD who were awaiting cataract surgery. Fluorescein angiography was performed preoperatively and at the postoperative week 1, month 3, and month 12 visits. Incidence of neovascular AMD development within 12 months after operation was the primary outcome measure.

Results  A total of 108 subjects were enrolled. Of 86 eyes with preoperatively photographically confirmed nonneovascular AMD, 71 had gradable images by month 12. Neovascular AMD was observed in 9 of 71 eyes (12.7%; 95% confidence interval, 6.0%-22.7%). The progression rate between week 1 and month 12 decreased to 3 of 65 eyes (4.6%; 95% confidence interval, 1.0%-12.9%) after excluding 5 neovascular events identified on the postoperative week 1 visit and 1 case with missing photographs at this visit.

Conclusion  The low incidence rate of neovascular AMD development between 1 week and 1 year after cataract surgery did not support the hypothesis that cataract surgery increases the risk of AMD progression. Several eyes appeared to have disease progression on postsurgery week 1 fluorescein angiograms, suggesting that many cases of presumed progression to neovascular AMD following cataract surgery may have been present prior to cataract surgery, but not recognized owing to lens opacity.

Author Affiliations: Department of Preventive Medicine, Stony Brook University School of Medicine (Dr Dong); and the Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland (Drs Stark, Al-Hazzaa, S. B. Bressler, Solomon, and N. M. Bressler and Ms Jefferys).

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