Outcomes of Cataract Surgery in Patients With Exudative Age-related Macular Degeneration and Macular Fluid

Abstract

To investigate whether having macular fluid on optical coherence tomography (OCT) prior to cataract surgery adversely affected vision or anatomic outcomes after cataract surgery in patients with exudative age-related macular degeneration (AMD). Retrospective cohort study. We examined all patients who underwent cataract surgery and were receiving intravitreal anti-vascular endothelial growth factor (anti-VEGF) injections from January 1, 2012 through December 31, 2016. There were 81 eyes that underwent cataract surgery and had received at least 1 intravitreal anti-VEGF injection for a diagnosis of exudative AMD within 6months prior to surgery. Data collected included the development of subretinal or intraretinal macular fluid, or subretinal hemorrhage, in the 6months following surgery; number of injections; best-corrected visual acuity (BCVA); and central subfield thickness (CST). There was a significant improvement between preopertive and postoperative BCVA when comparing all patients (P values < .0001) and no significant difference in CST before and after surgery (P > .05). There were 23 eyes with fluid on the preoperative OCT. There were no differences in final BCVA or CST and no difference in the development of fluid postoperatively when compared to patients without fluid preoperatively (all P values > .05). These patients also saw a significant improvement in BCVA (P= .006). In a real-world setting, patients with both cataracts and wet AMD may safely undergo cataract surgery. Patients with stable preoperative fluid on OCT should be considered for cataract surgery, as these patients did well postoperatively, with no worsening of their neovascular process.