Abstract
Purpose :
To determine the best-corrected vision (BCVA) and anatomical changes after cataract surgery in patients with wet age-related macular degeneration (wAMD) who were being treated with intravitreal aflibercept (IVA) with the treat-and-extend regimen (TER).
Methods :
All patients who had undergone cataract surgery and were receiving IVA with TER for wAMD at the Chiba University Hospital between February 2015 and February 2017 were studied. There were 18 eyes of 18 patients treated with IVA using TER for 6 months prior to the cataract surgery and had been followed for at least 1 year after the cataract surgery. During the TER, the treatment intervals were sequentially extended or shortened by approximately 2 weeks. The outcome measures were the changes in the BCVA, central retinal thickness (CRT), central choroidal thickness (CCT) relative to that before the surgery, the mean number of injections, the duration of the injections, and the incidence of dry macula at 6 months before, and 6 and 12 months after the cataract surgery.
Results :
The mean preoperative period was 2.0±0.7 years (mean±SD), and the mean postoperative follow-up period was 1.7±0.6 years. The mean preoperative number of injections were 17.3±6.7. The mean preoperative BCVA was 1.21±0.57 logMAR units which improved to 0.19 ±0.27 logMAR units at 6 months (P<0.001) and remained at 0.19±0.29 logMAR units at 12 months (P<0.001). The BCVA of all patients was unchanged or was significantly improved at 12 months. The mean CRT and CCT were not significantly changed during the study period. The mean number of injections was 6.9±2.5 during the 12 postoperative months. Six eyes (33%) required a decrease in the interval between injections after the surgery, and 9 eyes (50%) were able to maintain the same interval. Three eyes (17%) had a dry macula at 12 months.
Conclusions :
Cataract surgery significantly improves the BCVA of patients with wAMD being treated with IVA with a TER. After cataract surgery, the interval of injections may need to be shortened relative to that before the surgery.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.