Abstract
Purpose: :
To assess the benefits of cataract surgery in patients with ARM in terms of visual acuity and quality of life.
Methods: :
Forty–two eyes of 30 patients were included in this prospective study between October 2003 and January 2005. The eyes were divided into two groups : the first group (n = 12) with geographic atrophy and neovascularization (severe stage), and the second group (n=30) with drusen and retinal pigment epithelium abnormalities (moderate stage). Assessment included best corrected visual acuity (BCVA) and quality of life measures (VF–14 questionnaire) before surgery and 1 month after surgery.
We used color fundus photography before and after cataract surgery to grade maculopathy stage.
Results: :
In the first group, mean preoperative and postoperative BCVA were, respectively, 20/320 and 20/160. There was no statistical difference but a trend towards improvement in BCVA (p>0.05). In term of quality of life, the score of VF–14 was 31.3/100 before surgery and 44/100 one month after cataract surgery. There was a statistical difference between pre– and postoperative VF–14 (p<0.05). In the second group, mean preoperative and postoperative BCVA were, respectively, 20/80 and 20/25. There was a statistical difference between preoperative and postoperative BVCA (p<0.05). In term of quality of life, the score of VF–14 was 62.7/100 before surgery and 81.3/100 one month after surgery. There was a statistical difference between pre– and postoperative VF–14 (p<0.05).
One eye (6.25 %) developed choroidal neovascularization 12 months after cataract surgery.
Conclusions: :
The main interest of this study is to separate early and late stage of ARM and to evaluate in a prospective study : visual acuity, quality of life and satisfaction. This study shows a benefit in terms of visual acuity, satisfaction and quality of life in the majority of patients with age–related maculopathy after cataract surgery, even in late stage of ARM. Indeed, we noticed a marked improvement of visual acuity in cases of early stage of ARM, and a slight improvement of visual acuity in late stage of ARM. Quality of life and satisfaction were improved in both stages. In conclusion, cataract surgery is justified in patients with ARM.
Keywords: cataract • age-related macular degeneration • quality of life