Freeman, Cataract Surgery and Age-Related Macular Degeneration
Purpose: To determine whether cataract surgery is associated with an increased prevalence of
age-related macular degeneration (AMD) in three independent population-based data sets.
Design: Cross-sectional study
Methods: Study Populations. Data were used from the Salisbury Eye Evaluation (2,520 people
from Salisbury, MD ages 65-84), Proyecto VER (4,774 Hispanic individuals from Arizona ages
40 and over), and the Baltimore Eye Survey (4,396 people from Baltimore, MD ages 40 and
over). Main Outcome Measure: AMD as determined by retinal photographs or clinical exam.
Results: A history of cataract surgery was associated with an increased prevalence of late AMD
in all three data sets after adjusting for age, race, gender, and smoking, but odds ratios were not
individually statistically significant. The odds ratio for the combined analysis was 1.7 (95% CI:
1.1-2.6). Having a severe cataract in the eye was also associated with a slightly higher
prevalence of late AMD, although the combined odds ratio was not statistically significant
(OR=1.4, 95% CI 0.8-2.4). Overall, increasing time since cataract surgery was not associated
with late AMD.
Conclusions: A history of cataract surgery may be associated with an increased prevalence of
late AMD. However, having a severe cataract in the eye may also be associated with a higher
prevalence of late AMD. Additional research is needed to investigate whether a causal
relationship exists between cataract surgery and AMD or whether this relationship is due to
residual confounding or bias.
Word Count: 3,434
Section Code: (CL)
Keywords: cataract surgery, age-related macular degeneration, epidemiology