Mark Gillies, Vincent Daien, Vuong Nguyen, Nigel Morlet, Jennifer Arnold, Rohan Essex, Stephanie Young, Alex Hunyor8, Daniel Barthelmes
Purpose: To evaluate the long-term changes in visual acuity (VA), choroidal neovascular (CNV) lesion activity, and frequency of anti-vascular endo- thelial growth factor (VEGF) injections after cataract surgery in patients with neovascular age-related macular degeneration (nAMD).
Methods: Treatment-na?ve phakic eyes with nAMD tracked using a prospective registry, commencing anti-VEGF therapy from Jan. 1, 2006 with at least 12 months of follow-up prior to and following cata- ract surgery were considered. Three controls (phakic treatment-na?ve nAMD) per case were matched on the following characteristics to assess the effect of cataract surgery on the course of nAMD: treatment duration before cataract surgery, baseline VA and age and length of follow-up.
Results: We included 556 eyes (139 cases and 417 controls). Eyes that underwent cataract surgery gained a mean (95%CI) of 10.6 letters (95%CI: 7.9, 13.3; P<0.001) 12 months following surgery; 27.5% had gained ? 3 lines and 2.2% had lost ? 3 lines of VA. The proportion of visits where the CNV lesion was graded as active in the 12 months following cat- aract surgery was higher in eyes undergoing cataract surgery than in matched controls (49.4% vs. 43.1%; P<0.001). Eyes undergoing cataract surgery received more injections (mean [SD]) in the 12 months fol- lowing surgery than their respective controls (5.5 [3.2] vs. 4.9 [2.9]; P=0.009). Conclusions: Cataract surgery appears to be beneft- cial for eyes receiving intravitreal therapy for nAMD. Patients may require closer post-operative attention because their CNV lesion may become more active and need more frequent anti-VEGF treatment.