Surgery for cataracts in people with age-related macular degeneration

Abstract

Background Cataract and age-related macular degeneration (AMD) are significant causes of decreased vision in the elderly that often occur simultaneously. Although cataract surgery is an effective treatment for cataract-induced visual loss, some clinicians suspect that such an intervention may increase the risk of progression of underlying AMD and thus have deleterious effects on vision. Objectives The objective of this review was to evaluate the effectiveness and safety of cataract surgery in eyes with AMD. Search strategy We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (which contains the Cochrane Eyes and Vision Group Trials Register) (The Cochrane Library, Issue 4, 2008), MEDLINE (January 1966 to November 2008), EMBASE (January 1980 to November 2008) and Latin American and Caribbean Literature on Health Sciences (LILACS) (January 1982 to November 2008). There were no language or date restrictions in the search for trials. The electronic databases were last searched on 4 November 2008. Selection criteria We planned to include randomized controlled trials (RCTs) and quasi-randomized trials of eyes affected by both cataract and AMD in which cataract surgery would be compared to no surgery. Data collection and analysis Two authors independently evaluated the search results against the inclusion and exclusion criteria. Discrepancies were resolved by discussion. Main results We found no RCTs, thus no analysis was conducted. Evidence was limited to non-randomized clinical trials and prospective cohort and case-control studies. Authors' conclusions At this time, it is not possible to draw reliable conclusions from the available data to determine whether cataract surgery is beneficial or harmful in people with AMD. Physicians will have to make practice decisions based on best clinical judgement until controlled trials are conducted and their findings published.

Cataract surgery and age‐related macular degeneration. An evidence‐based update

“…The effect of cataract surgery on progression of AMD was previously evaluated by a Cochrane review (Casparis et al. ). That review only included data from published randomized controlled trials, resulting in a recommendation based on one included study.…”

Phacoemulsification Surgery in Eyes with Neovascular Age-Related Macular Degeneration

“…The strongest evidence supporting development of advanced AMD in the postoperative period was provided by large population-based epidemiologic studies [ 4 – 7 ]. However, a cochrane review of the literature was unable to determine whether cataract surgery was beneficial or harmful in patients with AMD [ 18 ]. More recently, data from the Age-Related Eye Disease Study (AREDS) concluded that cataract surgery is safe in the setting of dry AMD and did not accelerate progression to advanced sight threatening forms of AMD [ 16 , 17 ].…”

Full‐field Electroretinography in Age‐related Macular Degeneration: can retinal electrophysiology predict the subjective visual outcome of cataract surgery?

“…Much has been written about the risks and benefits of cataract surgery in patients with AMD (Casparis et al 2017). In particular, there is evidence to show that cataract surgery may be associated with increased choroidal neovascular membrane activity in exudative AMD (Daien et al 2018).…”