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Nimesh Arvind Patel, Ninel Gregori, Benjamin Reinherz, Anny Rodriguez, William Feuer, Raquel Goldhardt; Cataract Surgery and Quality of Life with Correlation to Pre-Operative Potential Acuity in Patients with Age-Related Macular Degeneration. Invest. Ophthalmol. Vis. Sci. 2018;59(9):4783.
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© ARVO (1962-2015); The Authors (2016-present)
Factors predicting positive outcomes in cataract surgery in patients with age related macular degeneration (AMD) are unclear. In this prospective study, we assessed the vision and quality of life (QOL) improvement in patients with AMD undergoing cataract surgery using the validated NEI VFQ 25 and LV VFQ questionnaires and correlated them to pre-operative characteristics.
Consecutive patients with AMD undergoing cataract surgery at the Miami Veterans Administration Hospital were recruited. Pre-operative data was collected including age, gender, visual acuity (VA), type of AMD, potential acuity with pinhole (PAP), glare acuity, and type of cataract. Patients were given a NEI VFQ25 and LV VFQ questionnaire at preoperative evaluation, post-operative month 1 (POM1) and post-operative month 6 (POM6). Baseline VA in the operated eye were stratified into better or worse than 20/200 for analysis. Analysis was corrected for VA in the non-operative eye. The primary outcomes were QOL questionnaire scores and LogMAR best corrected VA. Average QOL improvements were compared with the paired t-test or 2 way ANOVA. Bivariate associations were examined with Pearson’s correlation.
The study included 95 patients. There were 92 men and 3 women with average age 79 and range 58-96. The median pre-op baseline VA were 20/80 and 20/70 in the operated and fellow eyes, respectively. There were 55 (59%) eyes with wet AMD and 38 (41%) eyes with dry AMD. The Mean Average (SD) composite NEI VFQ 25 scores improved from 51.3 (20.4) baseline to 75.0 (24.3) (p<0.001) at POM1, and 77.7 (24.3) (p=0.001) at POM6. The 2 way ANOVA demonstrated that 1 and 6 month improvements in both VFQ25 and LVVFQ were greater (all p<0.05) in patients with better baseline acuities but did not differ by type of AMD (all p>0.3). These differences remained significant after adjusting for baseline fellow eye acuity for LVVFQ. Baseline PAP and glare and the difference between them were not correlated with VFQ25 or LVVFQ improvement (all p>0.08).
There was a significant vision and quality of life benefit in performing cataract surgery on patients with AMD and visually significant cataracts. This benefit was maintained in both exudative and non exudative AMD across all subsets.
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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