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Robin D Hamilton, Anastasia Tasiopoulou, Adam Mapani, Panagiotis Vasilopoulos, Gabriella Preston; Recurrence of Choroidal Neovascularization after cataract operation in Age Related Macular Degeneration. Invest. Ophthalmol. Vis. Sci. 2018;59(9):1468. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To determine the recurrence of Choroidal Neovascularization (CNV) after cataract operation in patients who had received treatment with anti-VEGF injections (Ranibizumab and/or Aflibercept) for neovascular Age-Related Macular Degeneration(nAMD).
Patients were identified by retrospective review of electronic records of all patients at Moorfields Eye Hospital who had received anti-VEGF treatment for nAMD between April 2012 and April 2017. The study group comprised of patients who had received anti-VEGF treatment for nAMD and also had cataract surgery within this time (n=300). A control group consisted of patients with nAMD previously treated with anti-VEGF injections with no prior or no requirement for catract surgery (n=447). The recurrence of CNV and the time to this recurrence were examined for both groups
26488 cataract operations were performed over 5 years. 2810 (10.6%) had a concurrent diagnosis of AM. 300 of 2810 (10.6%) patients had anti-VEGF during the study period. Of the 300 in the study group of 179 patients (59.67%) had prior Anti-VEGF and then showed CNV recurrence after cataract operation. They had a mean of 18.94 injections prior to the surgery. Mean time from their last injection to the operation was 12.74 weeks. Postoperatively, they required a mean number of 5.95 injections. The mean time to CNV recurrence was 11 weeks with 20% reactivation more than 12 weeks after the operation. In addition, there were 42 patients(14%) in the study with no history of Anti-VEGF use, who underwent cataract operation who subsequently developed signs of nAMD requiring anti-VEGF treatment with a mean time of 42.88 weeks after the operation. From 2810 patients with AMD operated for cataract at Moorfields in this period, the risk of nAMD conversion triggered by cataract operation is estimated to 1.5%. In the control group, 95 out of 447 patients (21.25%) showed CNV reactivation. Their mean time in the stable clinic prior to their recurrence was 24.4 weeks. They required 5.75 injections for the management of the recurrence. Comparing the time to recurrence between the study and control group, there was no statistically significant difference (P>0,3)
Cataract operation does not appear to increase the recurrence of CNV in patients with nAMD or to have effect on the time to recurrence and on the frequency of anti-VEGF injections required postoperatively
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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