The Association of Cataract and Cataract Surgery With the Long-term Incidence of Age-Related Maculopathy

Abstract

To examine the association between cataract and cataract surgery and the 10-year incidence of agerelated maculopathy (ARM). Methods: A population-based cohort study of persons aged 43 to 86 years at baseline, living in Beaver Dam, Wis, of whom 3684 participated in a 5-year and 2764 in a 10-year follow-up. We used standardized protocols for physical examination, blood collection, health history, slitlamp and retroillumination photography of the lenses to determine the presence of cataract, and stereoscopic color fundus photography to determine the presence of ARM. We used the Kaplan-Meier (productlimit) survival approach and discrete linear logistic regression in analyses. Main Outcome Measures: The risk ratios (RRs) of persons with cataract or cataract surgery at baseline.

Early age-related maculopathy in eyes after cataract surgery

“…14 Our findings may also complement previous findings from large population-based cross-sectional and longitudinal studies showing an association between past cataract surgery and subsequent development of late ARM in a long term. [13][14][15]22 It is plausible that patients who undergo cataract surgery have an increased risk of developing early ARM in the short-medium term (1-3 years), which then progresses to late ARM over a longer term (at least 5 years). Further follow-up of this cohort 5-6 years after surgery would be useful to confirm or deny this possibility.…”

“…It has been postulated that cataract and ARM might occur frequently together because of shared genetic 25,26 or environmental factors, cohort including age, diet, 27,28 light exposure 29,30 and cigarette smoking. [31][32][33][34][35][36] Current available evidence, however, is weak and inconsistent 11,12,14,15 in support of an association between cataract and ARM.…”

“…The strongest evidence to date, came from a pooled data analysis of two large populationbased studies, 13 that showed a significantly increased 5-year incidence of late ARM (odds ratio (OR) 5.7, 95% confidence interval (CI) 2.4-13.6) in nonphakic (aphakic or pseudo-phakic) eyes compared to phakic eyes, after accounting for age, smoking, and the presence and severity of early ARM lesions at baseline. 13 The Beaver Dam Eye Study (BDES) has reported a significant association between cataract surgery performed prior to baseline and the incidence of late ARM after both [5][6][7][8][9][10][11][12][13][14] and 10-year 15 intervals. The potential for an increased late ARM risk after cataract surgery remains topical and controversial, as indicated by two recent editorials published in Archives of Ophthalmology.…”

Influence of blue light spectrum filter on short-wavelength and standard automated perimetries

“…Cataract extraction may be associated with an increased risk for developing age-related macular degeneration (1)(2)(3)(4) . A possible mechanism for this association is the increase in the susceptibility of the eye to phototoxic (light) damage after crystalline lens extraction (4) .…”

Age-related maculopathy and cataract surgery outcomes: visual acuity and health-related quality of life

“…20 Some population-based reports have suggested an increased long-term risk of developing late ARM in eyes after cataract surgery. [21][22][23] This study aimed to assess mid-to long-term visual and health-related quality of life (HRQoL) outcomes in a hospital-based sample of patients who had cataract surgery at least 1 year earlier, and to compare outcomes between patients with and without preoperative ARM, plus factors associated with poor outcomes.…”