Abstract
Purpose Cataract and age-related macular degeneration (AMD) are the common causes of blindness in the elderly. Although cataract surgery is the most effective treatment for cataract, some clinicians suspect that such interventions may accelerate the progression of AMD. Therefore, we carried out this meta-analysis to focus on demonstrating the effectiveness and safety of cataract surgery in eyes with AMD. Methods We performed a systematic literature search in the PubMed, EMBASE, and Cochrane Library databases, and the electronic databases were last searched in January 2019. We planned to include cohort trials of eyes affected by both cataract and AMD in which cataract surgery would be compared to no surgery. Two reviewers independently evaluated the search results against the inclusion and exclusion criteria. 8 trials were included for this meta-analysis. Results We used the Stata/12.0 to integrate the data that was extracted from the articles. Eight cohort trials with data from different study populations were included. In random effects model, the relative risk (RR) for the progression of AMD is 1.194 (95% CI 0.897–1.591). As for those grouped according to the follow-up year, the RR for longer than five years was 1.372 (95% CI 1.062–1.772). Conclusion We could draw out such a conclusion that there is still a positive correlation between cataract surgery and the progression of AMD, especially for the Asians. However, based on the current results, it is not possible to draw conclusions from existing studies on the impact of cataract surgery on early AMD development.
Highlights
Cataract and age-related macular degeneration (AMD) are both common causes of impaired visual acuity and blindness in the elderly population worldwide
Some prospective or retrospective studies [5,6,7] reported that progression of AMD occurred more often in the surgical eyes compared with the nonsurgical eyes
We search for keywords such as “macular degeneration, wet macular degeneration, choroidal neovascularization, geographic atrophy or age-related macular degeneration” and “phacoemulsification, cataract surgery, pseudophakia, intraocular lenses, postcataract aphakia or cataract extraction.”
Summary
Cataract and age-related macular degeneration (AMD) are both common causes of impaired visual acuity and blindness in the elderly population worldwide. Cataract progression is the most widespread cause of blindness worldwide [1]. Cataract surgery is the primary treatment that can clearly eliminate lens opacity. Blindness from cataract is very rare in developed countries where it is relatively easy to perform cataract surgery, but AMD remains the second leading cause of visual impairment in the elderly [2]. Concern has been raised that cataract surgery may increase the risk of incident AMD or progression of preexisting AMD. Some prospective or retrospective studies [5,6,7] reported that progression of AMD occurred more often in the surgical eyes compared with the nonsurgical eyes. A cross-sectional [12] study has explored this problem, but there are still no exact results
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