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Originally published In Press as doi:10.1167/iovs.08-2066 on July 3, 2008
 (Investigative Ophthalmology and Visual Science. 2008;49:4795-4800.)
© 2008 by The Association for Research in Vision and Ophthalmology, Inc.
DOI:  10.1167/iovs.08-2066
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Cataract Surgery and the Risk of Aging Macula Disorder: The Rotterdam Study

Lintje Ho,1,2 Sharmila S. Boekhoorn,1 Liana,3 Cornelia M. van Duijn,1 André G. Uitterlinden,1,4 Albert Hofman,1 Paulus T. V. M. de Jong,1,5,6 Theo Stijnen,1,7 and Johannes R. Vingerling1,2

1From the Departments of Epidemiology and Biostatistics, 2Ophthalmology, and 4Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands; the 3Medical Research Unit, Faculty of Medicine, University of Indonesia, Jakarta, Indonesia; the 5Department of Ophthalmology, Academic Medical Center, Amsterdam, The Netherlands; 6The Netherlands Institute for Neuroscience, RNAAS, Amsterdam, The Netherlands.

PURPOSE. To investigate still-controversial associations between prior cataract surgery and aging macula disorder (AMD) in a general population.

METHODS. Baseline lens status and risk of incident AMD (iAMD) were examined in participants of the prospective population-based Rotterdam Study at risk for AMD (n = 6032). Slit lamp examination was used to determine lens status and stereoscopic color fundus photography to determine the presence of AMD. Odds ratios (ORs) and corresponding 95% confidence intervals (CIs) were estimated with generalized estimating equation (GEE) models. Stratified analyses were also performed for CFH Y402H genotype.

RESULTS. After adjusting for age, sex, follow-up time, and the correlation between eyes, a history of cataract surgery was associated with incident dry late AMD (OR, 3.43; 95% CI, 1.82–6.49). This association remained significant after additional adjustment for smoking status and AMD stage at baseline (OR, 3.44; 95% CI, 1.68–7.08). No statistically significant association was found between prior cataract surgery and the incidence of wet late AMD or early AMD. Homozygous CFH Y402H carriers had higher risks for all types of AMD compared to heterozygotes and noncarriers after cataract surgery, particularly for dry AMD.

CONCLUSIONS. The findings imply that cataract surgery increases the risk of dry AMD, particularly in homozygous CFH Y402H carriers. The risk of AMD progression should be considered before recommending cataract surgery to patients with cataract and early AMD.






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