Br J Ophthalmol 2000;84:1343-1348
( December )
Is cataract surgery justified in patients with age related
macular degeneration? A visual function and quality of life assessment
A M Armbrechta, C Findlaya, S Kaushalb, P Aspinalla, A R Hillb, B Dhillona
a Princess
Alexandra Eye Pavilion, The Royal Infirmary of Edinburgh, Edinburgh
EH3 9HA, UK, b The Oxford Eye
Hospital, Oxford, UK
Correspondence to: Dr B Dhillon
bal.dhillon{at}eyepavilion.zzn.com
Accepted for publication 22 June 2000
AIMS To determine
whether patients with age related macular degeneration (ARMD) benefit
from cataract surgery in terms of visual function and quality of life
measures, and to assess the impact of surgery on the progression of ARMD.
METHODSA prospective
study was carried out of patients with and without ARMD undergoing
cataract surgery. Data were collected from 187 patients at the Princess
Alexandra Eye Pavilion, Edinburgh and the Oxford Eye Hospital, Oxford.
The patients were divided into three groups: (1) a control group with
ARMD and no surgery (n=41), (2) a study group of patients with ARMD who
underwent cataract surgery (n=90), and (3) a second control group of
patients without ocular comorbidities who underwent cataract surgery
(n=56). Visual function and quality of life assessments were carried
out at baseline and 3-5 months after baseline or surgery.
RESULTSThere were
significant improvements both in terms of quality of life and visual
function measures in the study group. Benefits were greater in patients
with moderate cataract irrespective of the degree of ARMD. No increased
incidence in progression to the "wet" form of ARMD was found.
Improvements in quality of life measures and visual function were more
pronounced in patients with no ocular comorbidities.
CONCLUSIONSPatients
with mild and moderate degrees of ARMD do benefit from cataract surgery
and the benefits are greater in patients with moderate degrees of lens
opacity. Longer follow up is required to assess the risk of increased
ARMD progression.
© 2000 by British Journal of Ophthalmology
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