Abstract
Purpose :
The purpose of this study was to investigate the outcomes of cataract surgery in patients with retinal vein occlusions (RVO) who were actively managed with intravitreal anti-vascular endothelial growth factor (VEGF) before and after cataract surgery.
Methods :
We examined all patients who underwent cataract surgery and were receiving intravitreal anti-VEGF injections from January 1st, 2012 through December 31st, 2017. There were 20 eyes that underwent cataract surgery and received at least one intravitreal anti-VEGF injection for a diagnosis of RVO within 6 months prior to surgery. Data collected included the development of subretinal or intraretinal macular fluid in the 6 months following surgery, timing of injections, number of injections, best corrected visual acuity (BCVA), and central subfield thickness (CST).
Results :
There was a significant improvement between pre- and post-operative BCVA when comparing all eyes (p values <0.0001) and no significant difference in CST before and after surgery (p >0.05). Twelve eyes (60%) developed new or worsening macular fluid post-operatively on optical coherence tomography. These eyes demonstrated a significant improvement in visual acuity (p = 0.019 at 1 month and p = 0.018 at 6 months) with no significant worsening of their retinal thickness (p values >0.05). Eleven eyes (55%) had macular fluid pre-operatively. These eyes saw a significant improvement in visual acuity (p = 0.02 at 1 month and p = 0.04 at 6 months) with no worsening of the CST.
Conclusions :
In a real world setting, patients with cataracts who are actively managed for RVO with anti-VEGF agents may undergo cataract surgery and see an improvement in their visual acuity. More than half of eyes developed worsening macular fluid which required persistent therapy, but this fluid did not appear to affect 6 month visual outcomes. Eyes did not have to be fluid-free pre-operatively to see a significant improvement in visual acuity.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.