4
Freeman, Cataract Surgery and Age-Related Macular Degeneration
DESIGN
The three population-based studies to be used for this cross-sectional analysis, the
Salisbury Eye Evaluation, Proyecto VER, and Baltimore Eye Survey, were conducted according
to the guidelines established in the Declaration of Helsinki. In addition, the projects were
approved by the appropriate Internal Review Boards of the Johns Hopkins University. All
subjects provided written informed consent.
METHODS
Study Population: Salisbury Eye Evaluation
The Salisbury Eye Evaluation (SEE) project identified a population-based random sample
of elderly people between the ages of 65-84 years old living in Salisbury, MD in 1993. Details
about sample recruitment and methods are described elsewhere
13
. A total of 65% of those
invited to participate completed both the home questionnaire and the medical exam resulting in
2,520 participants.
Observation Procedures
Data were collected on history of previous cataract surgery by clinical exam. At the
clinical exam, photographs of the retina were taken and then assessed in a masked fashion by
trained graders for signs of AMD such as choroidal neovascularization, geographic atrophy,
hyperpigmentation, non-geographic atrophy, and drusen. Information on age, sex, race, and
smoking habits were also collected by interviewer-administered questionnaire. There were 471
participants who had cataract surgery on 718 eyes. Information on when cataract surgery
occurred was obtained after the initial exam by review of medical records (232 people or 49%)
or phone calls (98 people or 21%) to participants. Date of cataract surgery could not be obtained
