Exacerbation of senile macular degeneration following cataract extraction

Six eyes in four patients had hemorrhagic detachment of the retinal pigment epithelium following cataract extraction. All eyes had evidence of nonexudative senile macular degeneration preoperatively as manifested by drusen or alterations in the retinal pigment epithelium, or both. Postoperatively, all eyes had evidence of a subretinal neovascular membrane manifested by the presence of subretinal hemorrhage or by evidence on fluorescein anglography. We believe cataract extraction may cause changes in the choroidal hemodynamics that allow pre-existing new blood vessels to leak or bleed, or induces the formation of choroidal neovascularization in a predisposed eye.