Long-Term Vision After Cataract Surgery in AMD: Helia Ashourizadeh, MD

Cataract surgery improves vision at every stage of age-related macular degeneration (AMD), but the size and durability of that benefit depend on disease severity, according to Helia Ashourizadeh, MD, postdoc research fellow, Massachusetts Eye and Ear, who presented an analysis of IRIS Registry data at the American Academy of Ophthalmology 2026 Annual Meeting.

The retrospective study included 120,000 eyes of adults 50 years and older who underwent cataract surgery between 2016 and 2022. Eyes with early, intermediate, advanced dry, or neovascular AMD were matched 1:1 with eyes without AMD and followed for 3 years after surgery.¹ The aim, Ashourizadeh said, was “to evaluate the magnitude and durability of visual acuity improvements after cataract surgery” in patients with AMD.

Visual acuity improved after surgery across all AMD stages, but patients with AMD had poorer outcomes than those without the disease. The gap widened during follow-up, peaking at 0.16 logMAR, or about 8 ETDRS letters, at about 3 years.

Gains were generally sustained over time. The exception was patients with geographic atrophy, or advanced dry AMD, who returned to their preoperative visual acuity about 30 months after surgery. No other AMD stage showed that decline.

Older age, male sex, White race, and non-Hispanic ethnicity were associated with worse outcomes. Ashourizadeh cautioned that these associations may reflect differences in health care utilization or some residual imbalance in their AMD severity despite statistical adjustment.

“The main clinical outcome is that cataract surgery does improve visual acuity in AMD patients,” Ashourizadeh said. “However, preoperative staging of the disease would help to counsel patients on what to expect after cataract surgery and to set clear expectations for their visual acuity outcomes in long-term follow-ups.”

Reference

Ashourizadeh H, Gilbert JB, Ross C, et al. Visual acuity outcomes of cataract surgery in patients with age-related macular degeneration. Presented at: AAO 2026 Annual Meeting; October 9-12, 2026; New Orleans, LA.