The Effects of Cataract Surgery on Patients With Wet Macular Degeneration


      To explore whether cataract surgery contributes to the progression of wet age-related macular degeneration (wet AMD).


      Retrospective cohort study.


      Retrospective review was performed of consecutive patients with wet AMD who underwent cataract surgery at the midpoint of a 1-year study window. A control arm included wet AMD eyes treated with anti–vascular endothelial growth factor (VEGF) injections that did not undergo cataract surgery for a 1-year period. Best-corrected visual acuity (BCVA), number of anti-VEGF injections, and optical coherence tomography (OCT) features were compared between the 2 arms.


      Forty eyes in the surgical group and 42 in the nonsurgical group were included. BCVA was equivalent in the first half of the study, and became significantly better in the surgical group vs the nonsurgical group (0.23 ± 0.65 vs 0.11 ± 0.59 logMAR improvement, P = .049). There was no change in the number of injections given 6 months before vs after the midpoint in the surgical group (P = .921). The mean OCT central retinal thickness became greater in postsurgical eyes compared to nonsurgical eyes (265.4 ± 98.4 μm vs 216.4 ± 58.3 μm, P = .011). Surgical eyes were more likely to develop new or worse cystoid changes after the study midpoint (13 surgical eyes [54.2%] vs 9 nonsurgical eyes [28.1%], P = .048).


      Cataract surgery leads to vision improvement and does not appear to contribute to worsening of wet AMD. However, anatomic changes based on OCT analysis suggest a subclinical susceptibility to postoperative cystoid macular edema or exacerbation of choroidal neovascularization.
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      Steven S. Saraf received his medical degree from the David Geffen School of Medicine at UCLA and is currently completing his residency at Henry Ford Hospital in Detroit, Michigan. He has aspirations to enter a fellowship in uveitis and ocular inflammation followed by retina and vitreoretinal surgery.

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      • The Effects of Cataract Surgery on Patients With Wet Macular Degeneration
        American Journal of OphthalmologyVol. 160Issue 6
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          I read a recent article by Saraf and associates, entitled “The Effects of Cataract Surgery on Patients With Wet Macular Degeneration,”1 with great interest. In their study, new development or worsening of cystoid changes was more frequently noted in eyes that had undergone cataract surgery than in eyes that had not undergone surgery. Nevertheless, visual acuity was significantly better in the eyes with the surgery than in the eyes without the surgery, suggesting that cataract surgery could be beneficial in patients with wet age-related macular degeneration (AMD).
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