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Homayoun Tabandeh, Nauman Chaudhry, David S. Boyer, Veronica Konjara, Pheobe Novack; Outcomes of Cataract Surgery in Patients with Neovascular Age-Related Macular Degeneration in the Era of Anti-VEGF Therapy. Invest. Ophthalmol. Vis. Sci. 2011;52(14):3539.
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Purpose: To evaluate visual outcomes, choroidal neovascular complex (CNV) status, and adverse events in patients with visually significant cataract and neovascular age-related macular degeneration (nvAMD) who underwent cataract surgery.
Retrospective Study. Thirty four eyes of 32 patients with nvAMD treated by anti-VEGF therapy who underwent cataract surgery
BCVA at the time of cataract surgery was 20/40 or greater in 3 (9%) eyes, 20/50 to 20/100 in 19 (56%) eyes, and 20/200 or less in 12 (35%) eyes. Mean pre-cataract surgery LogMAR equivalent was 0.75 + 0.42 (range 0.1-2.3). At the last follow-up (mean 13.5, range 6-39 months) the BCVA was 20/40 or greater in 15 (44%) eyes, 20/50 to 20/100 in 11 (32%) eyes, and 20/200 or less in 8 (24%) eyes. The BCVA had significantly improved compared to prior to cataract surgery with a mean change in LogMAR equivalent of 0.23 + 0.25 (p<0.0001) at 2 months, 0.22 + 0.34 (p=0.001) at 6 months, and 0.19 + 0.51 (p=0.01) at last follow-up. Subjects received an average of 0.34 injections / month after cataract surgery compared to 0.47 injections / month prior to cataract surgery. Of the 24 eyes that were in a drug-free phase, recurrence of leakage requiring anti-VEGF therapy occurred in 9 (38%) at 2 months, 18 (75%) at 6 months, and 21 (88%) at the last follow-up. Perioperative macular adverse events did not occur in any of the eyes.
In the era of anti-VEGF therapy cataract surgery is associated with significant visual improvement in patients with nvAMD and visually significant cataract. Cataract surgery does not appear to be associated with increased rate of recurrence or increased frequency of intravitreal injections in the intermediate term.
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