April 2012

 

RESIDENT

 

Outcomes of cataract surgery in patients with neovascular age-related macular degeneration in the era of anti-vascular endothelial growth factor therapy


Homayoun Tabandeh, M.D., M.S., Nauman A. Chaudhry, M.D., David S. Boyer, M.D., Veronica A. Kon-Jara, M.D., Harry W. Flynn Jr., M.D.
   

J Cataract Refract Surg. (April) 2012; 38:677-682

Purpose: To evaluate the visual outcomes, choroidal neovascular complex status, and adverse events in patients with visually significant cataract and neovascular age-related macular degeneration (AMD) who had cataract surgery.

Setting: Private practices, Beverly Hills, Calif., and New London, Conn.

Design: Case series

Methods: Data were abstracted from the medical records of patients with neovascular AMD treated by anti-vascular endothelial growth factor (anti-VEGF) therapy who had cataract surgery. The main outcome measures were Snellen corrected distance visual acuity (CDVA), perioperative adverse events, and status of the choroidal neovascular complex.

Results: The study enrolled 30 eyes of 28 patients. The CDVA was 20/40 or better in 10% of eyes pre-operatively and 40% post-operatively; 20/50 to 20/100 in 53% and 33%, respectively; and 20/200 or worse in 37% and 27%, respectively. The change in CDVA from pre-operatively to post-operatively was statistically significant, with a mean change of 0.22 logMAR 0.27 (SD) at 2 months (P<.0001), 0.220.36 logMAR at 6 months (P= .001), and 0.170.54 logMAR at the last follow-up (P=.01). Patients received a mean of 0.32 injections per month post-operatively compared with 0.49 injections per month pre-operatively. Perioperative macular adverse events did not occur in any eye.

Conclusions: With regular evaluations and appropriate treatment with anti-VEGF agents, cataract surgery did not appear to be associated with an increased incidence of perioperative complications or macular adverse events.

Financial disclosures: Dr. Tabandeh has financial interests with Alcon (Fort Worth, Texas) and Allergan (Irvine, Calif.). Dr. Boyer has financial interests with Alcon, Allergan, Genentech (South San Francisco), Regeneron (Tarrytown, N.Y.), Novartis (Basel, Switzerland), Pfizer (New York), and Optos (Marlborough, Mass.). No other author has a financial or proprietary interest in any material or method mentioned.

Outcomes of cataract surgery in patients with neovascular age-related macular degeneration in the era of anti-vascular endothelial growth factor therapy Outcomes of cataract surgery in patients with neovascular age-related macular degeneration in the era of
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