Abstract
Purpose :
Neovascular age-related macular degeneration (nAMD) and cataracts are leading, and often coexisting, causes of vision loss among older individuals. Studies focused on cataract surgery outcomes in nAMD patients have been limited and reveal mixed visual outcomes. The aim of this study was to evaluate visual acuity (VA) outcomes in patients with nAMD, compared with controls, undergoing cataract surgery.
Methods :
A retrospective, observational clinical study was conducted by identifying patients 18 years of age or older who underwent cataract surgery in routine clinical practice from 2012-2017. The nAMD group (n=188, mean age=79.1±8.3 years) consisted of nAMD patients without other concomitant vitreoretinal disease who received intravitreal anti-vascular endothelial growth factor (VEGF) therapy prior to cataract surgery. Age-matched controls (n=129, mean age=75.5±6.2 years) were cataract surgery patients without a concomitant ocular condition known to impact VA. ETDRS VA data was collected at pre-operative, post-operative month 1 (POM1), and POM12 visits. Statistical analysis was performed using Mann-Whitney U test.
Results :
Baseline demographics with regards to age, gender, and mean pre-operative VA were similar between the control (53±15.3 ETDRS letters) and nAMD groups (50±21.8 ETDRS letters; p=0.16). Both groups experienced a significant increase (expressed as mean increase ± S.D.) in VA from baseline at both POM1 (24±8.2 letters, p<0.001 for control; 8±20.3 letters p<0.001 for nAMD) and POM12 (26±7.0 letters, p<0.001 for control; 10±23.8 letters p<0.001 for nAMD) visits following cataract surgery (Figure 1). However, post-operative VA increase was greater for controls versus nAMD patients at both POM1 (24±8.2 vs. 8±20.3 letters; p<0.001) and POM12 (26±7.0 vs. 10±23.8 letters; p<0.001).
Conclusions :
Cataract surgery significantly improves VA over one year in nAMD patients, though less so than in healthy controls. Further studies are needed to elucidate prognostic factors for visual improvement after cataract surgery in nAMD patients.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.