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Cataract Surgery and Macular Degeneration!

Is there an increase risk after cataract surgery?

The studies linking Macular degeneration and cataract surgery are conflicting. The Beaver Dam study and Blue Mountain study found as high as a 3 fold increase in macular degeneration after cataract surgery. A more recent study in the Journal of Opthalmology showed no clear effect but advised caution.

There are several reasons for this sudden increase.

One might be the events of the surgical procedure; the shock to the eye, inflammation and use of pharmaceutical drops etc.
The second might be that the aging process is acelerated because of the loss of Ultraviolet protective effect to the human lens
The last and most interesting is the suppressive effect of cataract surgery. Suppression is a homeopathic law that states that the human body has an intelligence and that symptoms and disease develop to achieve a homeostasis or balance in the body. If the underly cause of disease is not treated a more serious disease will develop. A cataract is a symptom/ disease. Surgery does not treat the underly cause. The result is a more serious disease macular degeneration.

I advise individuals to delay cataract surgery until they have visually significant symptoms. I also strongly recommend alternative treatments to treat the underlying cause of cataracts for at least 3 months. If these improve your vision you don’t need surgery! If they don’t and you need surgery your body and eye will be in better state of health to reduce the incidence of complications and the development or progression of macular degeneration.

Here is a review of the studies 
The 5-year results of the Beaver Dam Eye Study and the Blue Mountains Eye Study. Study identified persons with and without a history of cataract extraction at a baseline examination and reexamined them for incident AMD at 5 and 10 years. They found an association between cataract surgery and the 5-year incidence of late AMD For the Beaver Dam Eye Study, cataract surgery before baseline was associated with an increased risk of advanced AMD and in the Blue Mountains Eye Study, there was a 3-fold increased risk of advanced AMD .

Risk of Advanced Age-Related Macular Degeneration after Cataract Surgery in the Age-Related Eye Disease Study Published in the Journal Opththalmology Feb 2009
This studied showed no clear effect of cataract surgery on the risk of progression to advanced AMD although it is contrary to previous studies.

Age-related macular degeneration (AMD) and cataract are 2 of the leading causes of visual impairment in the United States. The relationship between cataract surgery and the development of advanced AMD has generated interest among ophthalmologists. Concerns have been raised regarding the potential of cataract surgery to accelerate progression to advanced, vision-threatening forms of AMD in a number of studies.

In the AREDS population that was followed up carefully at frequent, regular intervals for a long period, it seems that cataract surgery was not associated with a clinically important increase in the rates of development of advanced AMD.

However, it remains important that individuals with large drusen and pigmentary changes have an understanding of their risk for progression to advanced AMD with or without cataract surgery and that this risk is discussed with the patient before cataract surgery. Persons with intermediate AMD (bilateral large drusen) or with unilateral advanced AMD should be aware of the fact that the risk of developing advanced AMD is as high as 50% in 5 years. These results are contrary to the results of some previously published epidemiologic studies, including 2 reports that each pooled data from different population-based studies.