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Sindhu Krishnan, Lauren Branchini, Caio Regatieri, Jay Duker; The Effect of Cataract Surgery on Exudative Age-Related Macular Degeneration Being Treated by Intravitreal Anti-VEGF Agents. Invest. Ophthalmol. Vis. Sci. 2011;52(14):111.
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Age-related macular degeneration (AMD) is the leading cause of blindness in the United States. There is conflicting data as to whether or not cataract surgery affects the progression of pre-existing AMD. The purpose of this study is to evaluate the effect of cataract surgery on patients receiving intravitreal anti-VEFG therapy for exudative AMD.
In a retrospective chart review covering (08/05/2000 to 11/01/2010), patients with exudative AMD treated with anti-VEGF injections that had undergone cataract surgery were identified. Best corrected visual acuity, retinal thickness as measured by the OCT, and frequency of intravitreal injections were recorded both before and after surgery. The frequency of treatment was calculated as the total number of treatments over the period of time examined. Patients with retinal diseases other than AMD were excluded.
Forty-two eyes of thirty-two patients were identified over the time period of review . The mean age was 85±7.9 years (mean±SD) with a range of 68-102 years. Twenty-one patients were female and 11 were male. The mean follow-up after cataract surgery was 10 months (range from 1 to 84 months). There was no difference in BCVA via LogMAR when the following were compared: BCVA before cataract surgery (mean±SD = 0.8 ± 0.475), BCVA at first visit after cataract surgery (mean ± SD = 0.8 ± 0.557) and BCVA at the latest follow-up (mean ± SD = 0.9 ± 0.531, P>0.05). The mean retinal thickness before anti-VEGF treatment was 292.7±20.4 which was significantly greater than before cataract surgery (mean±SD = 229±62.3 m, P 0.05). The frequency of treatment before surgery (mean= 0.203) was significantly higher than the frequency of treatment postoperatively (mean = 0.08, P < 0.05).
In this population, patients with wet AMD demonstrated no difference in retinal thickness after cataract surgery. Further, they required significantly less frequent treatment post-operatively vs. preoperatively. This suggests that cataract surgery does not significantly worsen the course of pre-existing wet AMD being concurrently treated with anti-VEGF injections.
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