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The authors present the findings of a retrospective study looking at the progression of wet age-related macular degeneration (AMD) in patients who underwent cataract surgery. They recruited a series of 111 patients of which 38 were men and 73 were women. On average, patients received 25 anti-VEGF injections prior to cataract surgery and the average time between the last injection and the surgery was 30 days. All patients received three monthly baseline anti-VEGF injections as a baseline with different time intervals post cataract surgery. The treatment interval was shortened according to progression of the wet AMD. All patients had their eyes examined using OCT scans (central subfield macular thickness (CSMT) was recorded) and fluorescein angiography and / or indocyanine green angiography prior to surgery and were reviewed by a retinal specialist. Visual acuity was examined with a Snellen chart 18 weeks before and after the surgery. CSMT decreased significantly at the first recording after surgery (p=0.001) and one year postoperatively (p=0.003), visual acuity also showed improvement (p<0.001) for both the first postoperative recording and one year afterwards. Anti-VEGF treatment intervals lengthened despite the surgery at one year (p=0.246). CSMT increased over 30% compared to the preoperative recording in one patient (0.9%). Factors that did not have an association with macular changes or treatment after surgery included: macular status at surgery, wet AMD subtype, comorbidity of type II diabetes, systemic drugs and topical anti-inflammatory medication. There was no correlation between the number of anti-VEGF injections and CSMT postoperatively (r=−0.051, p=0.619) nor with CSMT changes at one year postoperatively (r=0.091, p=0.426). Some limitations of this study include the small cohort size and the time interval between pre- and postoperative patient review and cataract surgery was not standardised due to the retrospective nature of this study.

Effect of cataract surgery on wet age-related macular degeneration activity.
Karesvuo P, Elbaz U, Achiron A, et al.
2021; Epub ahead of print.
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Kareem Waleed Alsaffarini

York Hospital, UK.

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