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Cited by 229Retinal Diseases and TreatmentsIntraocular Surgery and LensesRetinal and Macular Surgery

Cataract surgery and the 5-year incidence of late-stage age-related maculopathy

Wang, Jie Jin, Klein, Ronald, Smith, Wayne, Klein, Barbara E.K, Tomany, Sandy, Mitchell, Paul·2003·Ophthalmology
DOI 10.1016/s0161-6420(03)00816-9
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Abstract

Purpose To assess whether cataract surgery in older persons increases risk for the development of late-stage age-related maculopathy (ARM).Design Combined analysis of longitudinal data from two population-based cohorts, the Beaver Dam Eye Study and Blue Mountains Eye Study.Participants The Beaver Dam Eye Study examined 4926 persons aged 43 years or older at baseline and re-examined 3684 after 5 years. The Blue Mountains Eye Study examined 3654 persons aged 49 years or older at baseline and re-examined 2335 after 5 years.Methods The two studies used similar protocols for retinal photography and photographic grading. We defined incident late-stage ARM as the development of neovascular ARM or geographic atrophy in eyes without either lesion type at baseline that was confirmed by consensus between the study investigators. Nonphakic eyes included eyes that were aphakic or pseudophakic at baseline. Eye-specific data were analyzed. Age- and study site-adjusted relative risks were calculated using the Cochran-Mantel-Haenszel method. Multivariate-adjusted odds ratios (ORs) were also estimated using generalized estimating equation models.Results Of the 6019 participants examined after 5 years, 11,391 eyes were considered at risk for developing late-stage ARM, including 315 nonphakic and 11,076 phakic eyes. Late-state ARM (either neovascular ARM or geographic atrophy) developed in 6.0% to 7.5% of nonphakic eyes (10 of 168 right and 11 of 147 left eyes), compared with 0.7% of phakic eyes (40 of 5504 right and 37 of 5572 left eyes) during the 5-year period. Age- and study site-adjusted 5-year relative risks were 2.8 (95% confidence interval [CI], 1.6-5.1) for right and 3.7 (95% CI, 2.1-6.4) for left eyes. After further adjustment for gender, smoking, and the presence of indistinct or reticular drusen or pigmentary abnormalities at baseline, nonphakic eyes had a substantially higher risk for developing either late-stage ARM lesion compared with phakic eyes, OR = 5.7 (95% CI, 2.4-13.6).Conclusions Pooled findings from these two large population-based cohorts support the hypothesis that cataract surgery in older persons may be associated with an increased subsequent risk for developing late-stage ARM, particularly neovascular ARM.

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  • The systematic review included 18 prospective and cross-sectional studies and 8 case control studies, contributing 94,058 patients and 3,178 late AMD cases.

    “In total, data from 18 prospective, cross-sectional studies and 8 case control studies [12,24-26,28,30,31,33-47,49-54,57-73] were included in the final analysis, contributing a sample of some 94,058 patients (ranging from 261 to 22,071) including 3,178 (ranging from 8 to 776) late AMD cases.”

    From Clinical risk factors for age-related macular degeneration: a systematic review and meta-analysis (2010) · cites this paper as [24]

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Authors
Wang, J. J., Klein, R., Smith, W., Klein, B. E. K., Tomany, S., & Mitchell, P.
Affiliations
  • The University of Sydney (AU)
  • University of Newcastle Australia (AU)
  • University of Wisconsin–Madison (US)
Corresponding author
Mitchell, Paul
ORCID
Venue
Ophthalmology
Publisher
Elsevier BV
Published
2003-10
Volume
110
Issue
10
Pages
1960-1967
ISSN
0161-6420 (ISSN-L)
DOI
10.1016/s0161-6420(03)00816-9
OpenAlex
W1495502816
Cited by
229
References
49
Citations by year
2026: 4 · 2025: 5 · 2024: 4 · 2023: 7 · 2022: 4 · 2021: 4 · 2020: 8 · 2019: 7 · 2018: 5 · 2017: 11 · 2016: 10 · 2015: 12 · 2014: 9 · 2013: 12 · 2012: 12
FWCI
14.77
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Ophthalmology (publishedVersion)
  • PubMed (publishedVersion)
Funders
National Eye Institute (EY0-6594, U10EY006594)
Topics
  • Health Sciences › Medicine › Ophthalmology › Retinal Diseases and Treatments
  • Health Sciences › Medicine › Ophthalmology › Intraocular Surgery and Lenses
  • Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Retinal and Macular Surgery
Keywords
cataract surgery, age-related maculopathy, geographic atrophy, pseudophakia, aphakia, postoperative risk, Beaver Dam Eye Study, Blue Mountains Eye Study, older adults, fundus photography
MeSH terms
Adult, Aged, Aged, 80 and over, Cataract Extraction, Female, Humans, Macular Degeneration, Male, Middle Aged, New South Wales, Risk Factors, Wisconsin, Cohort Studies, Incidence, Odds Ratio

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