Macular Degeneration and Cataract Surgery

Did you know? For many years it has been controversial whether having cataract surgery could accelerate the development of advanced macular degeneration. Some patients have cataract surgery, and not long after, develop worsening of their macular degeneration. Patients, of course, will often blame the cataract surgery. (I have at least one patient who falls into that category). What confounds this logic, though, is that cataracts occur with aging, as does macular degeneration. Patients may experience macular degeneration worsening with or without having had cataract surgery.

At last a well-designed study has addressed this question. The Age-Related Eye Disease Study (AREDS) was conducted between 1992 and 2005 and followed over 8,000 eyes of over 4,000 patients. The study was designed to assess the effect of antioxidants and mineral supplements on macular degeneration. The study assessed the development of advanced macular degeneration and history of cataract surgery at six month intervals during the study.

The results showed that appromately 20% of the eyes underwent cataract surgery during the study. Of the eyes undergoing surgery, 6% developed severe macular degeneration. Of the eyes not undergoing surgery, 7% developed severe macular degeneration. The results of the two groups did not significantly differ statistically.

It can be safely said that modern cataract surgery in unlikely to be related to worsening of macular degeneration.

Did you also know? The AREDS study originally found that their combination of zinc and antioxidants (now found in Ocuvite and others) modestly reduced the risk of progression for eyes with early signs of macular degeneration. The AREDS II study, ongoing now, is investigating the possible roles of omega-3 fatty acids, lutein, and zeaxanthin. It is also investigating if the dosage of zinc can be reduced and whether beta-carotene can be eliminated (for safety reasons in some patients).