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. 2020 Sep 6;10(9):e032745. doi: 10.1136/bmjopen-2019-032745

Table 4.

Summary of previous studies investigating the association between cataract surgery and AMD

Study Country Age range at baseline (y) Sample size Design Follow-up Results
(OR/RR/HR, 95% CI)
Adjustments
Significant association
Liu et al9 America >45 3087 Population-based cross-sectional NA AMD: 4.6 (2.5 to 8.6) Age, sex and SBP.
Klein et al (BDES)10 America 43–86 3684 at 5 years; 2764 at 10 years. Population-based cohort 10 y Late AMD: 3.81 (1.89 to 7.69);
GA: 3.18 (1.33 to 7.60);
Exudative AMD: 4.31 (1.71 to 10.9);
Progression: 1.97 (1.29 to 3.02).
Age, sex, SBP, heavy drinking and smoking, vitamin use.
Freeman et al (SEE, PVER, BES)11 America >49 SEE: 2,520; PVER: 4,774;
BES: 4396.
Population-based cross-sectional NA Late AMD: 1.7 (1.1 to 2.6) Age, race, sex and smoking.
Wang et al (BMES and BDES)12 Australia and America BMES:>49 BDES:>43 6019 Population-based cohort 5 y Late AMD: 5.7 (2.4 to 13.6) Age, study site, gender, smoking, reticular drusen or pigmentary abnormalities.
Cugati et al (BMES)13 Australia >49 2335 at 5 years; 1952 at 10 years Population-based cohort 10 y Late AMD: 3.3 (1.1 to 9.9);
NVAMD: 3.4 (1.1 to 10.9).
Baseline age, gender, smoking, and early AMD.
Kaiserman et al14 Israel >50 5913:29 565 Retrospective case–control 3 y PDT: 2.7 (2.4 to 5.7) Age, gender, country of birth, residency, socioeconomic status, hypertension, hyperlipidaemia, DM, congestive heart failure, ischaemic heart disease, and chronic renal failure.
Ho et al (Rotterdam Study)15 Netherlands >55 6032 Population-based cohort 5.7 Dry late AMD: 3.44 (1.68 to 7.08). Age, sex, follow-up time, smoking status and AMD stage at baseline.
Fraser-Bell et al (LALES)16 America >40 6357 Population-based cross-sectional NA Advanced AMD: 2.8 (1.0 to 7.8);
Retinal pigment: 1.6 (1.0 to 1.5);
Retinal pigment epithelial depigmentation: 2.2 (1.1 to 4.4).
Age, gender and smoking.
Klein et al (BDES)17 America 43–86 2626 early;
3329 late
Population-based cohort 20 y Late AMD: 1.96 (1.28 to 3.02) Age, age,2 sex, education, smoking, heavy drinking, history of CVD, DM, DBP.
Saraf et al18 America Case: 80.8±6.5
Control:
79.2±9.1
39:42 Retrospective case–control 1 y No more injections, but more susceptibility to cystoid macular oedema or exacerbation of choroidal neovascularisation. NA
Ho et al19 China, Taiwan >49 3465:10 395 Prospective case-control 5 y NVAMD: 2.68 (1.55 to 4.66). Geographical location, urbanisation level, monthly income, DM, hypertension, CVD and hyperlipidaemia.
Non-significant association
McCarty et al (VIP)20 Australia >40 4345 Population-based cross-sectional NA Not significant in the multivariate model. Age, cigarette smoker, use of ACE inhibitor, use of cholesterol-lowering medication.
Armbrecht et al21 Scotland >40 40:43 Prospective case control 1 y Only 2% of surgical eyes progressed to wet AMD. NA
Holger et al22 Germany 696:202 Retrospective case-control 1 y NVAMD: 1.30 (0.52 to 3.24). Age, baseline visual acuity.
Chew et al (AREDS)23 America 55–80 4577 Cohort study 5 y NVAMD: 1.08 (0.65 to 1.72);
Central GA: 0.98 (0.64 to 1.49).
Baseline age, gender, race, history of smoking.
Hooper et al24 Australia 67–92 27:29 Randomised controlled trial 6 m 3.7% of CNV in surgical group compared with none in control group (p=1.0). NA
Xu et al (BES)25 China >40 3826 Population-based cross-sectional NA Unilateral surgery was not associated with intereye differences in presence of early (p=0.99) or late AMD (p=0.99). NA
Wang et al (CSAMD)26 Australia >65 1244 Clinic-based cohort 3 y Late AMD: 0.74 (0.23 to 2.36);
Early AMD: 1.07 (0.74 to 1.65).
Age, sex, smoking or early AMD lesions at baseline.
Wang et al (CSAMD)27 Australia >65 1057 Clinic-based cohort 4–5 y Late AMD: 0.7 (0.4 to 1.2);
Early AMD: 0.7 (0.5 to 1.1).
Age, sex, baseline AMD status.
Park et al28 Korea >40 17 987 Population-based cross-sectional NA Any AMD: 1.02 (0.87 to 1.21);
Early AMD: 0.98 (0.82 to 1.16);
Late AMD: 1.42 (0.88 to 2.29).
Age, sex, smoking status, income, education level, occupation, DM, dyslipidaemia, overweight, hepatitis B surface antigens and anaemia.

AMD, age-related macular degeneration; AREDS, age-related eye disease study; BDES, Beaver Dam Eye Study; BES, Baltimore Eye Survey; BES, Beijing Eye Study; BMES, Blue Mountain Eye Study; CNV, choroidal neovascularisation; CSAMD, cataract surgery and age-related macular degeneration; CVD, cardiovascular disease; DBP, diastolic blood pressure; DM, diabetes mellitus; GA, graphic atrophy; LALES, Los Angeles Latino Eye Study; NA, not available; NVAMD, neurovascular age-related macular degeneration; PDT, photodynamic therapy; PVER, Proyecto VER; RR, risk ratio; SBP, systolic blood pressure; SEE, Salisbury eye evaluation; VIP, visual impairment project.