http://pubs.jamanetwork.com/ en-us Sun, 05 May 2013 00:00:00 GMT Sun, 05 May 2013 19:43:56 GMT Silverchair editor@pubs.jamanetwork.com webmaster@pubs.jamanetwork.com http://pubs.jamanetwork.com/article.aspx?articleID=1685136 Sun, 05 May 2013 00:00:00 GMT . <span class="paragraphSection"><div class="boxTitle">Importance</div>Age-related cataract is a leading cause of visual impairment in the United States. The prevalence of age-related cataract is increasing, with an estimated 30.1 million Americans likely to be affected by 2020.<div class="boxTitle">Objective</div>To determine whether daily oral supplementation with lutein/zeaxanthin affects the risk for cataract surgery.<div class="boxTitle">Design, Setting, and Patients</div>The Age-Related Eye Disease Study 2 (AREDS2), a multicenter, double-masked clinical trial, enrolled 4203 participants, aged 50 to 85 years, at risk for progression to advanced age-related macular degeneration.<div class="boxTitle">Interventions</div>Participants were randomly assigned to daily placebo; lutein/zeaxanthin, 10mg/2mg; omega-3 long-chain polyunsaturated fatty acids, 1 g; or a combination to evaluate the effects on the primary outcome of progression to advanced age-related macular degeneration.<div class="boxTitle">Main Outcomes and Measures</div>Cataract surgery was documented at annual study examination with the presence of pseudophakia or aphakia, or reported during telephone calls at 6-month intervals between study visits. Annual best-corrected visual acuity testing was performed. A secondary outcome of AREDS2 was to evaluate the effects of lutein/zeaxanthin on the subsequent need for cataract surgery.<div class="boxTitle">Results</div>A total of 3159 AREDS2 participants were phakic in at least 1 eye and 1389 of 6027 study eyes underwent cataract surgery during the study, with median follow-up of 4.7 years. The 5-year probability of progression to cataract surgery in the no lutein/zeaxanthin group was 24%. For lutein/zeaxanthin vs no lutein/zeaxanthin, the hazard ratios for progression to cataract surgery was 0.96 (95% CI, 0.84-1.10; P = .54). For participants in the lowest quintile of dietary intake of lutein/zeaxanthin, the hazard ratio comparing lutein/zeaxanthin vs no lutein/zeaxanthin for progression to cataract surgery was 0.68 (95% CI, 0.48-0.96; P = .03). The hazard ratio for 3 or more lines of vision loss was 1.03 (95% CI, 0.93-1.13; P = .61 for lutein/zeaxanthin vs no lutein/zeaxanthin).<div class="boxTitle">Conclusions and Relevance</div>Daily supplementation with lutein/zeaxanthin had no statistically significant overall effect on rates of cataract surgery or vision loss.<div class="boxTitle">Trial Registration</div>clinicaltrials.gov Identifier:NCT00345176.</span> 1 7 10.1001/jamaophthalmol.2013.4412 http://pubs.jamanetwork.com/article.aspx?articleID=1685136