Key Takeaways
- Cataract surgery was associated with a 22% higher overall risk of conversion from dry age-related macular degeneration to neovascular AMD.
Patients with dry age-related macular degeneration (AMD) who underwent cataract surgery had a modestly higher risk of progressing to neovascular AMD (wet AMD) compared with those who did not undergo surgery, according to an IRIS Registry study. However, the increased risk was most pronounced shortly after surgery and diminished over time.
Researchers analyzed 80,106 matched eyes from patients aged 55 years and older with early or intermediate dry AMD, including 40,053 eyes that underwent cataract surgery and an equal number that did not.
Cataract surgery was associated with a 22% increased risk of progression to wet AMD (P < 0.001).
The increased risk was most pronounced during the first year after cataract surgery, when the likelihood of conversion to nvAMD was approximately 2.5-fold higher. The association weakened over time and was no longer statistically significant by year 4. After 6 years of follow-up, the cumulative incidence of nvAMD was 17.7% in eyes that underwent cataract surgery versus 15.2% in eyes that did not.
The relationship between cataract surgery and progression to nvAMD varied by baseline AMD stage, with a weaker association observed in eyes with intermediate AMD.
The researchers noted that the time-dependent pattern may reflect increased surveillance or previously unrecognized nvAMD rather than a lasting effect of cataract surgery itself.
Reference
Ashourizadeh H, Gilbert JB, Ross C, et al; IRIS® Registry Analytic Center Consortium. Cataract Surgery and the Risk of Conversion from Dry to Neovascular Age-related Macular Degeneration in the IRIS© Registry. Ophthalmology. 2026;S0161-6420(26)00420-3. doi: 10.1016/j.ophtha.2026.06.016. Epub ahead of print. PMID: 42331067.
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