Safety and Effectiveness of Cataract Surgery with Simultaneous Intravitreal Anti-VEGF in Patients with Previously Treated Exudative Age-Related Macular Degeneration.

Abstract

To evaluate the safety and impact on visual acuity, retinal and choroidal morphology of simultaneous cataract surgeryand intravitreal anti-vascular endothelial growth factor on patients with visually significant cataracts and previously treated exudativeage-related macular degeneration. Prospective study, which included 21 eyes of 20 patients with exudative age-related macular degenerationsubmitted to simultaneous phacoemulsification and intravitreal ranibizumab or bevacizumab. The patients were followed for 12 monthsafter surgery using a pro re nata strategy. Visual acuity, foveal and choroidal thickness changes were evaluated 1, 6 and 12 monthspost-operatively. There was a statistically significant increase in mean visual acuity at one (13.4 letters, p < 0.05), six (11.5 letters, p < 0.05) andtwelve months (11.3 letters, p < 0.05) without significant changes in retinal or choroidal morphology. At 12 months, 86% of eyes wereable to maintain visual acuity improvement. There were no significant differences between the two anti-vascular endothelial growthfactor drugs and no complications developed during follow-up. Simultaneous phacoemulsification and intravitreal anti- vascular endothelial growth factor is safe and allows improvementin visual acuity in patients with visually significant cataracts and exudative age-related macular degeneration. Visual acuity gains weremaintained with a pro re nata strategy showing that in this subset of patients, phacoemulsification may be beneficial. Cataract surgery and simultaneous anti-vascular endothelial growth factor therapy improves visual acuity in patients withexudative age-related macular degeneration.