Download PDF
Klin Monbl Augenheilkd 2007; 224(4): 288-291
DOI: 10.1055/s-2007-962896
Originalarbeit

© Georg Thieme Verlag KG Stuttgart · New York

Besteht ein Zusammenhang zwischen einer Kataraktoperation und nachfolgender exsudativer altersbedingter Makuladegeneration? Eine große retrospektive Fallkontrollstudie

Does Cataract Surgery Increase the Risk of Exudative Age-Related Macular Degeneration? Results from a Large Retrospective Case-Control StudyM. Menghini1 , F. K. P. Sutter1 , D. Barthelmes1 , J. C. Fleischhauer1 , M. M. Kurz-Levin1 , M. M. Boesch1 , H. Helbig1
  • 1Augenklinik Universitätsspital Zürich, Schweiz (Chair: Prof. Dr. med. Klara Landau)
Further Information

Publication History

Eingegangen: 12.9.2006

Angenommen: 14.11.2006

Publication Date:
26 April 2007 (online)

Also available at
    Permissions and Reprints

Zusammenfassung

Hintergrund: Viele epidemiologische Studien vermuten einen Zusammenhang zwischen einer Kataraktoperation und der nachfolgenden Verschlechterung einer altersbedingten Makuladegeneration (AMD). Allerdings kann in epidemiologischen Studien nicht unterschieden werden, ob die Kataraktoperation tatsächlich die exsudative AMD auslöst oder ob Katarakt und AMD lediglich gemeinsame Risikofaktoren haben. Patienten und Methoden: Retrospektive Fallkontrollstudie an 1496 Augen. Untersucht wurden 984 Augen, bei welchen am Unispital Zürich zwischen Juli 1998 und April 2004 anlässlich einer Fluorszenzangiografie eine neu aufgetretene exsudative Makuladegeneration diagnostiziert wurde, sowie 512 Kontrollaugen (Partneraugen der Studienaugen) ohne AMD Spätform (trocken oder feucht). Ergebnisse: Wir fanden keinen signifikanten Unterschied im Linsenstatus zwischen der Studien- und Kontrollgruppe (227/984 [23,1 %] vs. 112/512 [21,8 %] pseudophak, p = 0,6487, OR = 1,071, 95 %CI = 0,8284 - 1,384). Bei Fällen mit beidseitiger Pseudophakie (n = 64) bestand kein statistisch signifikanter Unterschied beim zeitlichen Intervall zwischen Kataraktoperation und Neudiagnose der exsudativen AMD am Studienauge (225,9 ± 170,4 vs. 209,9 ± 158,2 Wochen, p = 0,27). Schlussfolgerungen: Unsere Resultate zeigen kein erhöhtes Risiko für das Auftreten einer exsudativen AMD nach Kataraktoperation.

Abstract

Background: Many epidemiological studies indicate a positive correlation between cataract surgery and the subsequent progression of age-related macular degeneration (AMD). Such a correlation would have far-reaching consequences. However, in epidemiological studies it is difficult to determine the significance of a single risk factor, such as cataract surgery. Patients and Methods: We performed a retrospective case-control study of patients with new onset exudative age-related macular degeneration to determine if cataract surgery was a predisposing factor. A total of 1496 eyes were included in the study: 984 cases with new onset of exudative AMD and 512 control eyes with early signs of age-related maculopathy. Lens status (phakic or pseudophakic) was determined for each eye. Results: There was no significant difference in lens status between study and control group (227/984 [23.1 %] vs. 112/512 [21.8 %] pseudophakic, p = 0,6487; OR = 1,071; 95 % CI = 0,8284 - 1.384). In cases with bilateral pseudophakia (n = 64) no statistically significant difference of the interval between cataract surgery in either eye and the onset of exudative AMD in the study eye was found (225.9 ± 170.4 vs. 209.9 ± 158.2 weeks, p = 0.27). Conclusions: Our results provide evidence that cataract surgery is not a major risk factor for the development of exudative AMD.

Schlüsselwörter

Kataraktoperation - exsudative altersbedingte Makuladegeneration (AMD)

Key words

cataract surgery - exudative age-related macular degeneration (AMD)

Literatur

  • 1 A randomized, placebo-controlled, clinical trial of high-dose supplementation with vitamins C and E, beta carotene, and zinc for age-related macular degeneration and vision loss: AREDS report no. 8.  Arch Ophthalmol. 2001;  10 1417-1436
    PubMedGoogle Scholar
  • 2 Abitbol O. et al . Should patients with age-related macular degeneration have cataract surgery?.  J Fr Ophtalmol. 2004;  9 Pt 2 3S87-3S92
    PubMedGoogle Scholar
  • 3 Armbrecht A M. et al . Cataract surgery in patients with age-related macular degeneration: one-year outcomes.  J Cataract Refract Surg. 2003;  4 686-693
    PubMedGoogle Scholar
  • 4 Binder S. Beeinflusst eine extrakapsuläre Kataraktextraktion den Verlauf der altersabhängigen Makuladegeneration (EKAM)? - Darstellung einer anlaufenden Studie.  Spektrum Augenheilkd. 2001;  15 178-180
    PubMedGoogle Scholar
  • 5 Blair C J, Ferguson Jr J. Exacerbation of senile macular degeneration following cataract extraction.  Am J Ophthalmol. 1979;  1 77-83
    PubMedGoogle Scholar
  • 6 Chaine G. et al . Case-control study of the risk factors for age related macular degeneration. France-DMLA Study Group.  Br J Ophthalmol. 1998;  9 996-1002
    PubMedGoogle Scholar
  • 7 Chua B E, Mitchell P, Cumming R G. Effects of cataract type and location on visual function: the Blue Mountains Eye Study.  Eye. 2004;  8 765-772
    PubMedGoogle Scholar
  • 8 Jong P T, Lubsen de J. The standard gamble between cataract extraction and AMD.  Graefes Arch Clin Exp Ophthalmol. 2004;  2 103-105
    PubMedGoogle Scholar
  • 9 Freeman E E. et al . Is there an association between cataract surgery and age-related macular degeneration? Data from three population-based studies.  Am J Ophthalmol. 2003;  6 849-856
    PubMedGoogle Scholar
  • 10 Friedman D S. et al . Prevalence of age-related macular degeneration in the United States.  Arch Ophthalmol. 2004;  4 564-572
    PubMedGoogle Scholar
  • 11 Klein R, Klein B E, Linton K L. Prevalence of age-related maculopathy. The Beaver Dam Eye Study.  Ophthalmology. 1992;  6 933-943
    PubMedGoogle Scholar
  • 12 Klein R. et al . The relationship of ocular factors to the incidence and progression of age-related maculopathy.  Arch Ophthalmol. 1998;  4 506-513
    PubMedGoogle Scholar
  • 13 Klein R, Klein B E, Cruickshanks K J. The prevalence of age-related maculopathy by geographic region and ethnicity.  Prog Retin Eye Res. 1999;  3 371-389
    PubMedGoogle Scholar
  • 14 Libre P E. Intraoperative light toxicity: a possible explanation for the association between cataract surgery and age-related macular degeneration.  Am J Ophthalmol. 2003;  5 961
    PubMedGoogle Scholar
  • 15 Liu I Y, White L, LaCroix A Z. The association of age-related macular degeneration and lens opacities in the aged.  Am J Public Health. 1989;  6 765-769
    PubMedGoogle Scholar
  • 16 Mitchell P. et al . Prevalence of age-related maculopathy in Australia. The Blue Mountains Eye Study.  Ophthalmology. 1995;  10 1450-1460
    PubMedGoogle Scholar
  • 17 Pollack A. et al . Age-related macular degeneration after extracapsular cataract extraction with intraocular lens implantation.  Ophthalmology. 1996;  10 1546-1554
    PubMedGoogle Scholar
  • 18 Smith B T, Belani S, Ho A C. Light energy, cataract surgery, and progression of age-related macular degeneration.  Curr Opin Ophthalmol. 2005;  3 166-169
    PubMedGoogle Scholar
  • 19 Hoeve van der J. Senile Maculadegeneration und senile Linsentrübung.  Graefes Arch Clin Exp Ophthalmol. 1918;  1-6
    PubMedGoogle Scholar
  • 20 Schaft van der T L. et al . Increased prevalence of disciform macular degeneration after cataract extraction with implantation of an intraocular lens.  Br J Ophthalmol. 1994;  6 441-445
    PubMedGoogle Scholar
  • 21 Wang J J. et al . Cataract surgery and the 5-year incidence of late-stage age-related maculopathy: pooled findings from the Beaver Dam and Blue Mountains eye studies.  Ophthalmology. 2003;  10 1960-1967
    PubMedGoogle Scholar

Dr. med. Florian K. Sutter

Augenklinik Universitätsspital Zürich

Frauenklinikstr. 24

8091 Zürich

Schweiz

Phone: ++41/44/2 55 11 11

Fax: ++41/44/2 55 44 72

Email: florian.sutter@usz.ch

      >