Cataract Surgery and the Risk of Aging Macula Disorder: The Rotterdam Study

¹ Ophthalmology, Erasmus Medical Center, Rotterdam, Netherlands; Epidemiology & Biostatistics, Erasmus Medical Center, Rotterdam, Netherlands
² Epidemiology & Biostatistics, Erasmus Medical Center, Rotterdam, Netherlands
³ Medical Research Unit, Faculty of Medicine, University of Indonesia, Jakarta, Indonesia
⁴ Epidemiology & Biostatistics, Erasmus Medical Center, Rotterdam, Netherlands; Netherlands Institute for Neuroscience, KNAW, Amsterdam, Netherlands; Ophthalmology, Academic Medical Center, Amsterdam, United States

^* To whom correspondence should be addressed. E-mail: j.vingerling{at}erasmusmc.nl.

	Abstract

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). We used slit lamp examination 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. We also performed stratified analyses for CFH Y402H genotype. Results After adjusting for age, gender, 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 additionally adjusting 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 Our 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 advising cataract surgery to patients with cataract and early AMD.

Key Words: age-related macular degeneration, cataract surgery, epidemiology, neovascularization

This article has been cited by other articles:

				B. E. K. Klein Is the Risk of Incidence or Progression of Age-Related Macular Degeneration Increased After Cataract Surgery? Arch Ophthalmol, November 1, 2009; 127(11): 1528 - 1529. [Full Text] [PDF]