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

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.

Kataraktoperation - exsudative altersbedingte Makuladegeneration (AMD)

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

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