Macular Degeneration and Cataract Surgery: Are They Compatible?
By the American Academy of Ophthalmology. Edited By Daniel Porter Mar. 23, 2022
Age-related macular degeneration (AMD) is a frustrating condition that diminishes your ability to see detail clearly. When you combine AMD’s loss of central vision with the blurriness from cataracts, you have a recipe for significant vision loss.
Can you have cataract surgery to restore some clear vision if you have macular degeneration? The answer is probably yes … but there are some factors your ophthalmologist will consider first.
Which Condition Impacts Your Vision Most: Cataracts or Macular Degeneration?
Before recommending cataract surgery, your ophthalmologist will want to find out whether most of your vision loss is caused by the cataract or by the AMD. Some people who have a lot of damage to their retina from macular degeneration won’t see much or any vision improvement from cataract surgery.
Your ophthalmologist will examine your retina and take photographs to assess its condition. They will also take a look at how cloudy your lens is to see how much vision the cataract may be blocking. And before recommending cataract surgery, your ophthalmologist will check your vision to see if a change in your eyeglass prescription or even low vision magnifiers may be enough to see better.
Having cataract surgery with AMD may not restore your ability to do up-close tasks, such as reading. Removing the cataract will allow more light to enter the eye, but that may not be enough for good central vision. We need a clear lens and a healthy retina for sharp vision.
Does Having Cataract Surgery Make Macular Degeneration Worse?
Because cataract surgery causes inflammation inside the eye, there is concern it could worsen AMD. A recent study looked at this risk for those with either dry AMD or wet AMD. While the results of earlier studies were inconsistent, this study (AREDS2, or the Age-Related Eye Disease Study 2) provides more clarity. The participants in the study were evaluated for up to 10 years. All told, the participants who had cataract surgery showed no increased risk of AMD progression versus those who did not. This is good news for those with AMD who may benefit from cataract surgery.
There is also no evidence that having cataract surgery will make you more likely to develop dry or wet AMD if you don’t already have it.
Fortunately, for those struggling with the double whammy of vision loss from both AMD and cataracts, studies have shown that cataract surgery can improve vision in those who are candidates for the procedure. You and your ophthalmologist can discuss your options for achieving better sight.