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

Abstract

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. Private practices, Beverly Hills, California, and New London, Connecticut, USA. Case series. 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. The study enrolled 30 eyes of 28 patients. The CDVA was 20/40 or better in 10% of eyes preoperatively and 40% postoperatively; 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 preoperatively to postoperatively was statistically significant, with a mean change of 0.22 logMAR ± 0.27 (SD) at 2 months (P<.0001), 0.22 ± 0.36 logMAR at 6 months (P=.001), and 0.17 ± 0.54 logMAR at the last follow-up (P=.01). Patients received a mean of 0.32 injections per month postoperatively compared with 0.49 injections per month preoperatively. Perioperative macular adverse events did not occur in any eye. 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.