Purchase this article with an account.
N. Kapoor, M. A. Weisbrod, F. Y. Chien, P. J. Rosenfeld; Cataract Surgery in Patients Receiving Intravitreal Bevacizumab or Ranibizumab for Neovascular AMD. Invest. Ophthalmol. Vis. Sci. 2009;50(13):237.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To investigate whether cataract surgery is safe and effective for neovascular AMD patients undergoing anti-VEGF therapy, we reviewed the visual acuity and anatomical outcomes following cataract surgery in this population.
The retrospective study protocol was approved by the Institutional Review Board (IRB) of the University of Miami. Chart reviews were performed on all patients undergoing intravitreal anti-VEGF therapy for neovascular AMD prior to cataract surgery from May 2005 through September 2008. Anti-VEGF therapy included both intravitreal bevacizumab or intravitreal ranibizumab. The main outcome variables included pre-operative and post-operative visual acuity (Va), number of intravitreal injections before and after surgery, fluid status of the macula based on OCT imaging, the correlation between potential acuity measurements and post-operative Va, and intraoperative as well as post-operative complications. Post operative data was collected for up to three months following surgery.
A total of 296 charts were reviewed to identify 44 patients and 47 eyes that met the inclusion criteria of receiving intravitreal bevacizumab or ranibizumab therapy for neovascular AMD prior to cataract surgery. OCT status was shown to be stable in 58% of patients, with 43% having fluid both before and after surgery on OCT and 15% of patients not displaying any fluid either before or after surgery. Forty-two percent of patients had OCT characteristics that changed, with 23% having fluid prior to but not after surgery and 19% having no fluid prior to surgery, but displaying the presence of fluid after surgery. The mean Snellen Va was 20/200- immediately prior to surgery and 20/100- after surgery. The total number of injections required per month pre-cataract surgery was 0.47 injections per month versus 0.29 injections per month after surgery during the study interval.
Cataract surgery appears to be well tolerated in neovascular AMD patients undergoing anti-VEGF therapy. On average, visual acuity improves after cataract surgery and there does not seem to be an increased need for re-injections following surgery.
This PDF is available to Subscribers Only