[PHACOEMULSIFICATION IN EYES WITH NEOVASCULAR AGE-RELATED MACULAR DEGENERATION (AMD)]

Age-related macular degeneration (AMD) is the leading cause of blindness in the western world. The debate continues over the safety of cataract surgery in the setting of neovascular (wet) AMD. This retrospective review aims to describe our experience in treating patients with wet AMD, who underwent cataract surgery by phacoemulsification.

We prepared a retrospective chart review of patients treated in our clinic between the years 2006 - 2013.

Forty-two eyes of 38 patients were included. Visual acuity (VA) improved significantly 1 month after cataract removal, without a significant change in retinal thickness. Twenty-six patients (62%) needed anti-VEGF injections during follow-up after surgery within an average period of 6 months. In eyes that were dry preoperatively, the re-injection rate was lower than those that were still wet (56 % vs. 80%) and the time from surgery to the first injection was longer in dry eyes (7 months and 3 months, respectively). Eyes that were injected with anti-VEGF up to one week before surgery had greater improvement in VA immediately after surgery but the proportion of those receiving injections (78%) was greater and the time to first injection post-surgery was earlier (3 months) compared to eyes that received the last injection 6 months or more prior to surgery ( 53 % and - 7 months).

Cataract removal improves vision in wet AMD patients. It is of great importance to treat these patients and try to reach dry retina prior to surgery and a close followup is needed after surgery. In eyes that were more stable within 6 months before surgery and their retina was dry, the re-injection rate post surgery was lower and the time to first injection was longer.