THE COURSE OF AGE-RELATED MACULAR DEGENERATION FOLLOWING BILATERAL CATARACT-SURGERY

BACKGROUND AND OBJECTIVE: Progression of age-related macular degenerat ion (AMD) following cataract surgery has been described. The aim of th is study was to investigate whether an uneventful postoperative maculo pathic course in one eye (the first eye) may predict a similar prognos is for the fellow eye (the second eye). PATIENTS AND METHODS: Thirty-t hree patients with bilateral, similar, early AMD (defined by the prese nce of drusen and/or pigmentary abnormalities on fundal examinations a nd by the absence of late leakage as documented by fluorescein angiogr aphy) who had undergone unilateral cataract surgery, had had a stable postoperative maculopathic course following the first operation, and w ere scheduled for cataract surgery in the second eye were prospectivel y observed for at least 1 year after the second operation. The course of maculopathy of the second eye was compared with that of the first e ye during the followup period of the second eye. RESULTS: A total of 9 of the second eyes (27.2%) showed progression to wet AMD. Of these, 1 patient (3%) had progression in both eyes and 8 patients (24.2%) had progression in the second eye only. The conditions of 2 of the first o perated on eyes (6.1%) deteriorated (P < .05). Hypertension (P < .05), soft drusen (P < .01), and Nd:YAG laser capsulotomy (P <.05) were ris k factors for development of wet AMD. CONCLUSION: In this study, 24.2% of the patients with early AMD who underwent bilateral cataract surge ry and had an uneventful maculopathic course in the first eye had wet AMD in the second eye. Thus, patients with early AMD and soft drusen u ndergoing bilateral cataract surgery should be monitored for early det ection of progression of maculopathy. Further prospective studies are needed to determine the course of maculopathy following cataract surge ry.