AREDS2 Cohort Analysis: Cataract Surgery Does Not Increase Risk of Progression to Advanced AMD

Article: Cataract surgery does not cause disease progression in people with AMD 
Source: National Eye Institute
Published: December 15, 2021 

According to the latest analysis of data from the Age-related Eye Disease Study 2 (AREDS2), a 5-year randomized controlled clinical trial, with up to 10 years of follow up, that tested combinations of dietary supplements for their ability to slow progression of age-related macular degeneration (AMD), no association was found between cataract surgery and progression of AMD to an advanced (late) stage, which is defined as presence of geographic atrophy or neovascularization. The analysis involved a subset of 4,553 AREDS2 participants’ eyes that at baseline did not have signs of advanced AMD and had not undergone cataract surgery. Among this group of AREDS2 participants, eyes that later developed cataracts and had cataract surgery were compared with eyes that did not undergo cataract surgery, with analysis of at least two years of follow-up after cataract surgery. Adjustments were made for many potential confounding factors. Senior author of the study explains, "The standard for removing cataracts, called phacoemulsification, where the lens is broken into tiny pieces, causes less trauma and inflammation than older techniques. This could help explain why past studies saw an association between cataract surgery and progression to advanced AMD and we didn’t." In terms of clinical counseling and decision making, she says, "Our results indicate people don’t need to avoid or delay cataract surgery for fear of worsening their AMD."

My rating of this study: ⭐⭐⭐

Bhandari S, Vitale S, Agrón E, et al. "Cataract Surgery and the Risk of Developing Late Age-Related Macular Degeneration: The Age-Related Eye Disease Study 2 Report Number 27." Ophthalmology.  15 November 2021. https://doi.org/10.1016/j.ophtha.2021.11.014