Risk of advanced age-related macular degeneration after cataract surgery in the Age-Related Eye Disease Study: AREDS report 25

Ophthalmology. 2009 Feb;116(2):297-303. doi: 10.1016/j.ophtha.2008.09.019. Epub 2008 Dec 16.


Purpose: To assess the risk of advanced age-related macular degeneration (AMD) developing after cataract surgery.

Design: Cohort study.

Participants: Four thousand five hundred seventy-seven participants (8050 eyes) from a multicenter, controlled, randomized clinical trial, the Age-Related Eye Disease Study (AREDS).

Methods: Development of advanced AMD, either neovascular (NV) AMD or geographic atrophy (GA), was evaluated with annual fundus photographs, and history of cataract surgery was assessed every 6 months. Cox proportional hazard models with time-dependent covariates were conducted for NV AMD and GA separately.

Main outcome measures: Neovascular AMD, GA, and central GA (CGA; involving the center of the macula).

Results: The Cox proportional hazards model of right eyes showed nonsignificant hazard ratios of 1.20 (95% confidence interval [CI], 0.82-1.75) for NV AMD, 0.80 (95% CI, 0.61-1.06) for GA, and 0.87 (95% CI, 0.64-1.18) for CGA. Similar results were obtained for left eyes: 1.07 (95% CI, 0.72-1.58) for NV AMD, 0.94 (95% CI, 0.71-1.25) for GA, and 0.86 (95% CI, 0.63-1.19) for CGA. For participants with advanced AMD in 1 eye (AREDS category 4), the hazard ratios for fellow eyes were 1.08 (95% CI, 0.65-1.72) for NV AMD and 0.98 (95% CI, 0.64-1.49) for CGA.

Conclusions: The AREDS results showed no clear effect of cataract surgery on the risk of progression to advanced AMD.

Financial disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • Aged, 80 and over
  • Antioxidants / therapeutic use
  • Atrophy
  • Cataract Extraction*
  • Dietary Supplements
  • Disease Progression
  • Female
  • Humans
  • Macular Degeneration / epidemiology
  • Macular Degeneration / etiology*
  • Macular Degeneration / prevention & control
  • Male
  • Middle Aged
  • Postoperative Complications*
  • Proportional Hazards Models
  • Prospective Studies
  • Retinal Pigment Epithelium / pathology
  • Risk Factors
  • Surveys and Questionnaires
  • Visual Acuity


  • Antioxidants