Association between Previous Cataract Surgery and Age-Related Macular Degeneration

Purpose: To assess the association between age-related macular degeneration (AMD) and previous cataract surgery. Methods: We studied 17,987 randomly selected participants from the Korea National Health and Nutrition Examination Survey who were aged ≥40 years and underwent additional ophthalmologic examinations in 2008‒12. The associations between previous cataract surgery and early/late AMD were identified using multivariate logistic regression analysis of data from right or left eyes. Clustered multivariate logistic regression analysis was performed using both eyes to assess inter-eye correlation in same subject. Previous cataract surgery and cataract subtypes were based on slit-lamp examination without pupil dilation. Early and late AMD diagnoses were based on non-mydriatic digital retinal image. Results: By univariate logistic regression, both early and late AMD prevalence were higher in subjects with pseudophakia/aphakia compared to subjects with cataract as a reference group, or subjects with phakic eye (including clear lens) as a reference group. In univariate logistic regression, both early and late AMD prevalence were higher in eyes with cataract or pseudo/aphakia compared to eyes with clear lens. However, after adjusting for age with multivariate logistic regression, all statistically significant differences in AMD prevalence among subgroups disappeared. Conclusions: We found no association between the previous cataract surgery and increased early/late AMD risk in our representative, large, national patient database. This suggests that increasing age, and not cataract surgery history, is predictive of AMD risk. These findings are limited by cross-sectional study and need to be replicated by other longitudinal observational studies.