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K. F. Mimouni, I. Eldar, R. Axer-Siegel, M. Kramer, L. Shani, D. Weinberger; Photodynamic Therapy for Psedophakic Eyes Compared to Eyes With Cataract. Invest. Ophthalmol. Vis. Sci. 2007;48(13):1799.
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© ARVO (1962-2015); The Authors (2016-present)
To investigate the outcome of photodynamic therapy (PDT) for choroidal neovascularization in pseudophakic eyes and to compare the findings with cataractous eyes.
The study group consisted of patients with subfoveal choroidal neovascularization secondary to age-related macular degeneration who were treated with PDT using verteporfin. All patterns of choroidal neovasculariztion were included. The same PDT protocol reported in the TAP and VIP studies was used in all patients. Fluorescein angiography, visual acuity test, and fundus examination were performed before each treatment every 3 months for at least 6 months. For the present study, the patients were divided into those with cataract (AREDS grade) or clear lenses and those with pseudophakic eye(s) and compared for background factors, number and timing of PDT treatments, duration of follow-up, angiographic features, and improvement in visual acuity.
Ninety-nine patients (107 eyes) were eligible for the study, of whom 43 (43%) had cataract (44 eyes), 53 (57%) had an intraocular lens implant (59 eyes), and 4 (4%) had clear lenses (4 eyes). The clear lens patients were dropped from analysis. Most of the choroidal neovasculariztion lesions were predominantly classic (84.1% in the cataract group, and 79.7% in the pseudophakic lens group). There was no statistically significant difference between the cataract and pseudophakic groups in number of PDT sessions needed (3.6 and 3.3, respectively) or duration of follow-up (9.6 and 9.3 months, respectively). After 6 months, the pseudophakic group showed significantly less loss of visual acuity than the cataract/clear-lens group: log MAR values rose from 0.75 at baseline to 0.88 in the cataract group, and from 0.65 to only 0.70 in the pseudophakic group (p=0.04). In addition, a greater proportion of the pseudophakic eyes were characterized by stabilized or improved visual acuity (49.1% vs. 36.4% of eyes in the cataract group), and absence of leakage from the lesion or evidense of scarred lesion (44% vs. 38.6%); however, neither of these differences achieved statistical significance.
PDT for choroidal neovascularization due to age-related macular degeneration appears to be at least as effective in pseudophakic eyes as in eyes with cataract. The pseudophakic eyes showed a significantly better visual acuity than the cataractous eyes at 6 months and a trend towards earlier scarring and less leakage.
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