Ask the doctor: Will cataract surgery worsen macular degeneration?

Q. I have been diagnosed with macular degeneration and cataracts in both eyes. Could cataract surgery worsen my macular degeneration?

A. Retina specialists like myself used to be concerned that cataract surgery might worsen macular degeneration. Results from some small studies indicated that there might be a problem. Cataracts act like a filter, blocking light, so when the cloudy lenses are removed and replaced with clear, artificial lenses, more light reaches the retina. It was thought that the additional light might harm the macula, which is the most light- sensitive part of the retina. Or maybe the trauma of the surgery was harmful. But these were just theories based on limited data. In 2009, results of an analysis of a large, NIH-funded study called the Age-Related Eye Disease Study (AREDS) were reported. The researchers found no association between cataract surgery and worsening of macular degeneration. Often one study isn't enough to settle a medical issue. But the AREDS results pretty much did, trumping the results of those earlier studies because it was large (about 4,500 volunteers) and followed people over a fairly long period (five years or longer).