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Effect of cataract surgery in patients with neovascular age-related macular degeneration: further evidence from disciform scars

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Abstract

Purpose

To evaluate the effect of cataract surgery on disease activation and visual outcomes in neovascular age-related macular degeneration (AMD).

Methods

In this retrospective case–control study, study arm consisted of neovascular AMD patients, who underwent phacoemulsification surgery. Patients did not have any disease activation at least 6 months before the inclusion, and all had at least 12-month follow-up thereafter. Control group consisted of phakic patients, who did not undergo eye surgery during the study period. Primary outcomes were the presence of the disease activation and the change in best-corrected visual acuity (BCVA).

Results

A total of 114 neovascular AMD patients [55 (48%) in exudative group and 59 (52%) in disciform group] were included. Preoperative logMAR BCVA was significantly improved after cataract surgery [0.8 (0.6–1.0) vs. 0.4 (0.4–0.7), P < 0.001 in exudative AMD; 1.85 (1.1–1.9) vs. 1.09 (0.8–1.9), P = 0.001 in disciform scar], but this improvement was not maintained during the study period in patients with both exudative AMD and disciform scar [0.6 (0.3–1.1), P = 0.313 in exudative AMD; 1.30 (1–1.9), P = 0.03 in disciform scar]. The incidence of disease activation was not statistically significant between surgery and control groups in patients with exudative AMD [5 (25%) patients in surgery group and 8 (22%) patients in the control group, P = 0.886, Cox proportional hazards regression analysis]. In disciform scar, disease activation was observed in 4 (17%) patients in the surgery group; however, no patient in the control group had disease activation (P = 0.009, HRs could not be estimated, 95% CI 0.001–43.49, Cox proportional hazards regression analysis).

Conclusion

Cataract surgery has benefit on early postoperative visual improvement in patients with neovascular AMD. The incidence of disease activation was not affected after surgery in exudative AMD.

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References

  1. Liu IY, White L, LaCroix AZ (1989) The association of age-related macular degeneration and lens opacities in the aged. Am J Public Health 79:765–769

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. Klein R, Klein BE, Linton KL (1992) Prevalence of age-related maculopathy. The beaver dam eye study. Ophthalmology 99:933–943

    Article  CAS  PubMed  Google Scholar 

  3. Syam PP, Eleftheriadis H, Casswell AG, Brittain GP, McLeod BK, Liu CS (2004) Clinical outcome following cataract surgery in very elderly patients. Eye 18:59–62

    Article  CAS  PubMed  Google Scholar 

  4. Jaffe GJ, Martin DF, Toth CA, Daniel E, Maguire MG, Ying GS, Grunwald JE, Huang J (2013) Comparison of age-related macular degeneration treatments trials research g: macular morphology and visual acuity in the comparison of age-related macular degeneration treatments trials. Ophthalmology 120:1860–1870

    Article  PubMed  PubMed Central  Google Scholar 

  5. Chew EY, Sperduto RD, Milton RC, Clemons TE, Gensler GR, Bressler SB, Klein R, Klein BE, Ferris FL III (2009) Risk of advanced age-related macular degeneration after cataract surgery in the age-related eye disease study: AREDS report 25. Ophthalmology 116:297–303

    Article  PubMed  Google Scholar 

  6. Hooper CY, Lamoureux EL, Lim L, Fraser-Bell S, Yeoh J, Harper CA, Keeffe JE, Guymer RH (2009) Cataract surgery in high-risk age-related macular degeneration: a randomized controlled trial. Clin Exp Ophthalmol 37:570–576

    Article  PubMed  Google Scholar 

  7. Lee TG, Kim JH, Chang YS, Kim CG, Kim JW (2014) Factors influencing the exudation recurrence after cataract surgery in patients previously treated with anti-vascular endothelial growth factor for exudative age-related macular degeneration. Graefes Arch Clin Exp Ophthalmol 252:1573–1579

    Article  CAS  PubMed  Google Scholar 

  8. Tabandeh H, Chaudhry NA, Boyer DS, Kon-Jara VA, Flynn HW Jr (2012) Outcomes of cataract surgery in patients with neovascular age-related macular degeneration in the era of anti-vascular endothelial growth factor therapy. J Cataract Refract Surg 38:677–682

    Article  PubMed  Google Scholar 

  9. Muzyka-Wozniak M (2011) Phacoemulsification in eyes with neovascular AMD treated with anti-VEGF injections. Eur J Ophthalmol 21:766–770

    Article  PubMed  Google Scholar 

  10. Rosenfeld PJ, Shapiro H, Ehrlich JS, Wong P, Marina, Groups AS (2011) Cataract surgery in ranibizumab-treated patients with neovascular age-related macular degeneration from the phase 3 ANCHOR and MARINA trials. Am J Ophthalmol 152:793–798

    Article  Google Scholar 

  11. Grixti A, Papavasileiou E, Cortis D, Kumar BV, Prasad S (2014) Phacoemulsification surgery in eyes with neovascular age-related macular degeneration. ISRN Ophthalmol 2014:417603

  12. Forooghian F, Agron E, Clemons TE, Ferris FL, Chew EY, Age-Related Eye Disease Study Research G (2009) Visual acuity outcomes after cataract surgery in patients with age-related macular degeneration: age-related eye disease study report no. 27. Ophthalmology 116:2093–2100

    Article  PubMed  PubMed Central  Google Scholar 

  13. Saraf SS, Ryu CL, Ober MD (2015) The effects of cataract surgery on patients with wet macular degeneration. Am J Ophthalmol 160(487–492):e481

    Google Scholar 

  14. Seddon JM, Sharma S, Adelman RA (2006) Evaluation of the clinical age-related maculopathy staging system. Ophthalmology 113:260–266

    Article  PubMed  Google Scholar 

  15. Fung AE, Lalwani GA, Rosenfeld PJ, Dubovy SR, Michels S, Feuer WJ, Puliafito CA, Davis JL, Flynn HW Jr, Esquiabro M (2007) An optical coherence tomography guided, variable dosing regimen with intravitreal ranibizumab (Lucentis) for neovascular age-related macular degeneration. Am J Ophthalmol 143:566–583

    Article  CAS  PubMed  Google Scholar 

  16. Holladay JT (1997) Proper method for calculating average visual acuity. J Refract Surg 13:388–391

    CAS  PubMed  Google Scholar 

  17. Schulze-Bonsel K, Feltgen N, Burau H, Hansen L, Bach M (2006) Visual acuities “hand motion” and “counting fingers” can be quantified with the freiburg visual acuity test. Investig Ophthalmol Vis Sci 47:1236–1240

    Article  Google Scholar 

  18. Kessel L, Erngaard D, Flesner P, Andresen J, Tendal B, Hjortdal J (2015) Cataract surgery and age-related macular degeneration. An evidence-based update. Acta Ophthalmol 93:593–600

    Article  PubMed  Google Scholar 

  19. Hartnett ME, Tinkham N, Paynter L, Geisen P, Rosenberg P, Koch G, Cohen KL (2009) Aqueous vascular endothelial growth factor as a predictor of macular thickening following cataract surgery in patients with diabetes mellitus. Am J Ophthalmol 148(895–901):e891

    Google Scholar 

  20. Noda Y, Ogawa A, Toyama T, Ueta T (2014) Long-term increase in subfoveal choroidal thickness after surgery for senile cataracts. Am J Ophthalmol 158:455–459

    Article  PubMed  Google Scholar 

  21. Ueta T, Inoue T, Yuda K, Furukawa T, Yanagi Y, Tamaki Y (2012) Intense physiological light upregulates vascular endothelial growth factor and enhances choroidal neovascularization via peroxisome proliferator-activated receptor gamma coactivator-1α in mice. Arterioscler Thromb Vasc Biol 32:1366–1371

    Article  CAS  PubMed  Google Scholar 

  22. Midena E, Radin PP, Pilotto E, Ghirlando A, Convento E, Varano M (2004) Fixation pattern and macular sensitivity in eyes with subfoveal choroidal neovascularization secondary to age-related macular degeneration. A microperimetry study. Semin Ophthalmol 19(1–2):55–61

    Article  PubMed  Google Scholar 

  23. Greenstein VC, Santos RA, Tsang SH, Smith RT, Barile GR, Seiple W (2008) Preferred retinal locus in macular disease: characteristics and clinical implications. Retina 28:1234–1240

    Article  PubMed  PubMed Central  Google Scholar 

  24. Mallah MK, Hart PM, McClure M, Stevenson MR, Silvestri G, White ST, Chakravarthy U (2001) Improvements in measures of vision and self-reported visual function after cataract extraction in patients with late-stage age-related maculopathy. Optom Vis Sci 78:683–688

    Article  CAS  PubMed  Google Scholar 

  25. Ma Y, Huang J, Zhu B, Sun Q, Miao Y, Zou H (2015) Cataract surgery in patients with bilateral advanced age-related macular degeneration: measurement of visual acuity and quality of life. J Cataract Refract Surg 41:1248–1255

    Article  PubMed  Google Scholar 

  26. Fletcher DC, Schuchard RA (2006) Visual function in patients with choroidal neovascularization resulting from age-related macular degeneration: the importance of looking beyond visual acuity. Optom Vis Sci 83:178–189

    Article  PubMed  Google Scholar 

  27. Rosenfeld PJ, Brown DM, Heier JS, Boyer DS, Kaiser PK, Chung CY, Kim RY, MARINA Study Group.et al (2006) Ranibizumab for neovascular age related macular degeneration. N Engl J Med 355:1419–1431

    Article  CAS  PubMed  Google Scholar 

  28. Brown DM, Kaiser PK, Michels M, Soubrane G, Heier JS, Kim RY, Sy JP, Schneider S, ANCHOR Study Group (2006) Ranibizumab versus verteporfin for neovascular age-related macular degeneration. N Engl J Med 355:1432–1444

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Ophthalmology, Ankara Atatürk Education and Research Hospital, Yıldırım Beyazıt University, Ankara, Turkey

    Mücella Arıkan Yorgun, Yasin Toklu & Meltem Ece Kar

  2. Department of Ophthalmology, Faculty of Medicine, Hacettepe University, Ankara, Turkey

    Basri Hasan Çakmak

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  1. Mücella Arıkan Yorgun
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  2. Yasin Toklu
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  3. Meltem Ece Kar
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  4. Basri Hasan Çakmak
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Correspondence to Mücella Arıkan Yorgun.

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Arıkan Yorgun, M., Toklu, Y., Kar, M.E. et al. Effect of cataract surgery in patients with neovascular age-related macular degeneration: further evidence from disciform scars. Int Ophthalmol 38, 459–467 (2018). https://doi.org/10.1007/s10792-017-0480-z

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  • DOI: https://doi.org/10.1007/s10792-017-0480-z

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