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Phacoemulsification in neovascular age-related macular degeneration: a safe procedure?

Session Details

Session Title: Quick Fire Free Paper Session 01

Session Date/Time: Thursday 26/09/2013 | 08:30-10:30

Paper Time: 09:00

Venue: Hall G1 (Level 2)

First Author: P.Freitas-da-Costa PORTUGAL

Co Author(s):    M. Falcao   J. Pinheiro-Costa   ?. Carneiro   F. Falc?o-Reis     

Abstract Details

Purpose:

To evaluate the safety and efficacy of cataract phacoemulsificatio in patients with neovascular age-related macular degeneration (AMD).

Setting:

Study performed at Hospital São João (Oporto, Portugal), a tertiary wealth care center.

Methods:

We performed a retrospective analysis of patients with neovascular AMD treated with anti-vascular endotelial growth factor (anti-VEGF) agents who underwent cataract surgery. All patients were treated according to a regimen of 1+PRN and were submitted to cataract phacoemulsification with a simultaneous anti-VEGF intravitreal injection (bevacizumab or ranibizumab). For this analysis, the best-corrected visual acuity (BCVA, with ETDRS charts) and the central retinal thickness (CRT) just prior to cataract surgery was redefined as the baseline BCVA and CRT, respectively. For the period of six months after surgery, the main outcome measures were change in BCVA and CRT, proportion of patients requiring retreatment, and adverse events.

Results:

Sixteen eyes of fifteen patients met the inclusion criteria. Mean baseline BCVA was 39.4 ± 15.2 letters. The mean BCVA change after surgery was statistically significant, both at first month (+9.9 letters, 95% CI [3.9 to 15.9], P = 0.003) and at sixth month (+5.6 letters, 95% CI [0.1 to 11.0], P = 0.047). Mean baseline CRT was 264.1 ± 138.8 μm, and no significant change occured during the follow-up period. Seven eyes (43.8%) were in a latent state (without treatment for at least six months) prior to the surgery, of which two eyes (28.6%) needed retreatment during the postoperative period. There were no reports of adverse events.

Conclusions:

In this subgroup of patients with neovascular AMD cataract surgery as phacoemulsification plus simultaneous anti-VEGF treatment proved effective, allowing a significant improvement of visual acuity at six months follow-up, without a worsening of baseline neovascular activity.

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