AMD type has no impact on timing of cataract surgery
Timing of cataract surgery did not affect outcomes among patients with wet age-related macular degeneration, according to a study published in Acta Ophthalmologica.
“Timing of cataract surgery in wet AMD patients should be adjusted according to patients’ needs,” Petteri Karesvuo, MD, a PhD student at Helsinki Retina Research Group and the department of ophthalmology at Helsinki University Hospital, and colleagues wrote. “We found no justification to support delaying surgery until dry macula has been achieved. Surgery should, therefore, not be postponed for these considerations in patients who require it.”
This retrospective registry-based study included 111 eyes with wet AMD that underwent cataract surgery between 2014 and 2018. The mean age of patients at time of surgery was 78.9 years. Karesvuo and colleagues analyzed best-corrected visual acuity and central subfield macular thickness at the time of wet AMD diagnosis, at the last recording before cataract surgery and again at first recording and 1 year following surgery. They recorded anti-VEGF injections at surgery, systemic and topical medication and postoperative anti-VEGF burden.
In almost all eyes studied, central subfield macular thickness decreased (280.1 ± 75.0 µm preoperatively to 268.6 ± 67.6 µm at the first postoperative recording, P = .001; and to 265.9 ± 67.9 µm at 1 year, P = .003), visual acuity improved (0.7 ± 0.46 logMAR preoperatively to 0.39 ± 0.4 at the first postoperative recording, and to 0.33 ± 0.34 at 1 year, P < .001 for both) and anti‐VEGF treatment intervals lengthened (6.53 ± 2.08 weeks prior to surgery to 7.03 ± 2.23 weeks at 1 year, and to 7.05 ± 2.57 weeks at the last documented visit, P = .035).
The researchers found macular status, wet AMD subtype, pre-diagnosis of type 2 diabetes, systemic and topical anti‐inflammatory medication were not associated with macular changes or with treatment intervals after surgery.
“Our study supports performing cataract surgery regardless of wet AMD activity when a potential improvement in visual acuity can be expected,” Karesvuo and colleagues wrote. “Neither the macular status prior to surgery nor the cumulative number of anti‐VEGF injections was associated with clinical outcomes postoperatively.”