Cataract surgery and macular degeneration – your questions answered

Posted: Wednesday 28 September 2022 at 00:00

Many people think they are not eligible for cataract surgery due to their macular condition, while others think cataract surgery has led to their diagnosis.

So, is there an association between cataract surgery and macular disease?

Consultant ophthalmologist and ophthalmic surgeon professor Gary Misson covered the topic in more detail at our latest My Macular and Me webinar, answering your frequently asked questions.

I have cataracts and AMD is it worth me having surgery?

According to professor Misson, there are several circumstances which make it worth having cataract surgery. These are:

  • If the cataracts are ‘clinically significant’. As professor Misson explained, this means removing your cataract would make your vision better, whether you have AMD or not.
  • If you are driving and wish to remain within the DVLA driving limit. Professor Misson added: “That assumes your AMD isn’t that bad and your cataracts are the main cause of preventing you from being within the legal limit for driving.”

Professor Misson did highlight that it is not worth removing the cataract if they are very small, as removing them is unlikely to improve your vision.

I’ve been told I have cataracts and that it is not worth having surgery because I also have AMD is this true?

“If your cataracts are not significant you’re unlikely to notice any benefit,” professor Misson said. “But, if your cataracts are dense then cataract surgery may be very beneficial. It certainly will improve your peripheral vision and the brightness of your vision, and also possibly colour.”

However, he warned anyone having surgery to have “realistic expectations”. He said: “If you have enough macular degeneration to affect your central vision then moving the cataract will not get your central vision back.” “It may not get you back to reading, it may not get you back to the DVLA standard, but it should improve your quality of life.”

Can cataract surgery make my macular degeneration worse?

Many people worry that cataract surgery will adversely affect their macular degeneration, but professor Misson does not think this is the case. At the webinar, he referenced a recent study in the Journal of Ophthalmology which concludes that cataract surgery did not increase the risk of developing late AMD among participants, with up to 10 years of follow up.

Read the full study

“Cataract surgery made my AMD worse”

 “I have some patients coming to be angry with me, annoyed with me, upset and sad because they feel cataract surgery has made their AMD worse,” he said.

But, as he explained, the risk of progression in dry and wet AMD isn’t generally associated with cataract surgery.

He added: “The problem is age-related macular degeneration is a progressive condition and cataract surgery will not halt that progression.

“After you’ve had your cataracts removed, after anyone’s had their cataracts removed, there’s a very great difference in vision from what it was like before the surgery to what it is like after the surgery and there may be a change and there may not necessarily be an improvement.”

For more answers to questions on cataract surgery and AMD, catch up on professor Misson's My Macular and Me webinar. 

If you have any questions about cataract surgery and macular degeneration the Macular Society's Advice and Information Service is here to help on 0300 3030 111.