Outcomes of Cataract Surgery in Patients with wet Form of Age-related Macular Degeneration Treated with Aflibercept.
str. 72 – 76
Autorzy: Małgorzata Seredyka-Burduk1,2, Magdalena Pol1, Grażyna Malukiewicz1, Bartłomiej Kałużny1,2.
1 Katedra Chorób Oczu Klinika Chorób Oczu Collegium Medicum w Bydgoszczy Uniwersytetu Mikołaja Kopernika w Toruniu
Kierownik Katedry: prof. dr hab. n. med. Grażyna Malukiewicz
2. Katedra Chorób Oczu Klinika Okulistyki i Optometrii Collegium Medicum w Bydgoszczy Uniwersytetu Mikołaja Kopernika w Toruniu
Kierownik Kliniki: prof. dr hab. n. med. Bartłomiej Kałużny
Purpose: The aim of the study was to evaluate the visual outcome after cataract surgery in patients with the wet form of age-related macular degeneration treated with aflibercept in the National Health Fund Drug Prescription Program. Secondly, it was hypothesized whether cataract surgery can influence best-corrected visual acuity and central retinal thickness in patients with the wet form of age-related macular degeneration.
Material and methods: We analyzed data of 53 eyes of 53 patients (35 women, 18 men) with the wet form of age-related macular degeneration who underwent uncomplicated cataract phacoemulsification during treatment with aflibercept intravitreal injections. The average age of our patients was 78.75 ± 6.23 years. Age-related macular degeneration activity was monitored during ophthalmological examination with optical coherence tomography evaluation every 1–2 months. All the patients were treated according to the National Health Fund Drug Prescription Program schedule. Cataract surgery did not change the regimen of visits associated with age-related macular degeneration therapy. We assessed BCVA best-corrected visual acuity and central retinal thickness in consecutive measurements during 6 months before and 6 months after cataract surgery.
Results: In 51 eyes we observed improvement of the visual acuity and in 2 cases visual acuity did not change. Mean best-corrected visual acuity, measured on Snellen’s chart, increased significantly – before surgery was 0.31 ± 0.20 (min 0.01, max 0.7) and 0.69 ± 0.24 (min 0.2, max 1.0) on the last follow up visit. The average central retinal thickness before surgery was 396.26 ± 100.28 m and significantly decreased after surgery – amounted 390.26 ± 96.47 m. Patients received a mean of 2.70 ± 0.71 injections of aflibercept per six months postoperatively compared with 2.79 ± 0.78 injections in the same period postoperatively. We did not observe any perioperative macular adverse events.
Conclusions: Cataract surgery significantly improves visual acuity in patients with the wet form of age-related macular degeneration and does not increase the risk of progression of the age-related macular degeneration if the retina is stabilized (dry) prior to the operation. All patients after surgery need obligatory follow-up visits to plan future anti-vascular endothelial growth factor injections. Simultaneously with the improvement of vision after cataract surgery, the insight into the fundus of the eye improves which enables precise monitoring of macular degenerative changes.