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Randomized Controlled Trial
. 2009 Feb;116(2):297-303.
doi: 10.1016/j.ophtha.2008.09.019. Epub 2008 Dec 16.

Risk of advanced age-related macular degeneration after cataract surgery in the Age-Related Eye Disease Study: AREDS report 25

Emily Y Chew  1 , Robert D Sperduto, Roy C Milton, Traci E Clemons, Gary R Gensler, Susan B Bressler, Ronald Klein, Barbara E K Klein, Frederick L Ferris 3rd
Affiliations
Randomized Controlled Trial

Risk of advanced age-related macular degeneration after cataract surgery in the Age-Related Eye Disease Study: AREDS report 25

Emily Y Chew et al. Ophthalmology. 2009 Feb.

Abstract

Purpose: To assess the risk of advanced age-related macular degeneration (AMD) developing after cataract surgery.

Design: Cohort study.

Participants: Four thousand five hundred seventy-seven participants (8050 eyes) from a multicenter, controlled, randomized clinical trial, the Age-Related Eye Disease Study (AREDS).

Methods: Development of advanced AMD, either neovascular (NV) AMD or geographic atrophy (GA), was evaluated with annual fundus photographs, and history of cataract surgery was assessed every 6 months. Cox proportional hazard models with time-dependent covariates were conducted for NV AMD and GA separately.

Main outcome measures: Neovascular AMD, GA, and central GA (CGA; involving the center of the macula).

Results: The Cox proportional hazards model of right eyes showed nonsignificant hazard ratios of 1.20 (95% confidence interval [CI], 0.82-1.75) for NV AMD, 0.80 (95% CI, 0.61-1.06) for GA, and 0.87 (95% CI, 0.64-1.18) for CGA. Similar results were obtained for left eyes: 1.07 (95% CI, 0.72-1.58) for NV AMD, 0.94 (95% CI, 0.71-1.25) for GA, and 0.86 (95% CI, 0.63-1.19) for CGA. For participants with advanced AMD in 1 eye (AREDS category 4), the hazard ratios for fellow eyes were 1.08 (95% CI, 0.65-1.72) for NV AMD and 0.98 (95% CI, 0.64-1.49) for CGA.

Conclusions: The AREDS results showed no clear effect of cataract surgery on the risk of progression to advanced AMD.

Financial disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article.

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Conflict of interest statement

No authors have any financial/conflicting interests to disclose.

Figures

Figure 1
Figure 1. Graphical representation of risks and 95% confidence intervals
Ratio is Hazard Ratio (HR) for Cox models, Ratio (R) from matched-pair analysis, Odds Ratio (OR) for logistic regression. Values of HR, R and OR > 1 suggest increased risk of age-related macular degeneration in eyes following cataract surgery compared with non-surgery eyes. RE =Right eye, LE =Left eye, NVAMD = Neovascular age-related macular degeneration, GA = Geographic atrophy, CGA = Central geographic atrophy, Logistic Regr = Logistic Regression. Persons in Categories 2, 3, and 4 at baseline are at increasing risk of developing advanced AMD, as described in “Study Population.”
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