Outcomes of Cataract Surgery in Patients With Exudative Age-related Macular Degeneration and Macular Fluid.

Abstract

PURPOSE:

To investigate whether having macular fluid on optical coherence tomography (OCT) prior to cataract surgery adversely affected vision or anatomic outcomes after cataract surgery in patients with exudative age-related macular degeneration (AMD).

DESIGN:

Retrospective cohort study.

METHODS:

We examined all patients who underwent cataract surgery and were receiving intravitreal anti-vascular endothelial growth factor (anti-VEGF) injections from January 1, 2012 through December 31, 2016. There were 81 eyes that underwent cataract surgery and had received at least 1 intravitreal anti-VEGF injection for a diagnosis of exudative AMD within 6 months prior to surgery. Data collected included the development of subretinal or intraretinal macular fluid, or subretinal hemorrhage, in the 6 months following surgery; number of injections; best-corrected visual acuity (BCVA); and central subfield thickness (CST).

RESULTS:

There was a significant improvement between preopertive and postoperative BCVA when comparing all patients (P values < .0001) and no significant difference in CST before and after surgery (P > .05). There were 23 eyes with fluid on the preoperative OCT. There were no differences in final BCVA or CST and no difference in the development of fluid postoperatively when compared to patients without fluid preoperatively (all P values > .05). These patients also saw a significant improvement in BCVA (P = .006).

CONCLUSION:

In a real-world setting, patients with both cataracts and wet AMD may safely undergo cataract surgery. Patients with stable preoperative fluid on OCT should be considered for cataract surgery, as these patients did well postoperatively, with no worsening of their neovascular process.

• Authors: Matthew R Starr, Michael A Mahr, Andrew J Barkmeier, Raymond Iezzi, Wendy M Smith, Sophie J Bakri
• Journal: American journal of ophthalmology (Am J Ophthalmol) Vol. 192 Pg. 91-97 (08 2018) ISSN: 1879-1891 [Electronic] United States
• PMID: 29802819 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2018 Elsevier Inc. All rights reserved.

Chemical References

• Angiogenesis Inhibitors

Topics

• Aged
• Aged, 80 and over
• Angiogenesis Inhibitors (therapeutic use)
• Cataract (complications)
• Cataract Extraction
• Exudates and Transudates (diagnostic imaging)
• Female
• Humans
• Intravitreal Injections
• Lens Implantation, Intraocular
• Male
• Pseudophakia (physiopathology)
• Retrospective Studies
• Subretinal Fluid (diagnostic imaging)
• Tomography, Optical Coherence (methods)
• Treatment Outcome
• Visual Acuity (physiology)
• Wet Macular Degeneration (complications, drug therapy, physiopathology)