Combined cataract extraction and intravitreal bevacizumab in eyes with choroidal neovascularization resulting from age-related macular degeneration

Abstract

Combined phacoemulsification, IOL implantation, and intravitreal bevacizumab was a safe and efficacious treatment in patients with visually significant cataract and active subfoveal neovascularization.

Safety and Effectiveness of Cataract Surgery with Simultaneous Intravitreal Anti-VEGF in Patients with Previously Treated Exudative Age-Related Macular Degeneration

“…We did not study cataract surgery with simultaneous bevacizumab injection in patients with active exudative AMD as Furino et al 10 Even though, this study reported visual gains at one month, the long-term results of this approach are unknown.…”

“…The data presented included visual acuity results up to four months after the surgery and there is no reference to the percentage of patients that gained or lost vision. Furino et al 10 showed favorable results one month after combined phacoemulsification and bevacizumab in an active exudative AMD setting. Tabandeh et al 11 reported similar visual acuity gains in a follow-up period that was shorter than twelve months, in patients that had phacoemulsification whilst being treated with either ranibizumab or bevacizumab.…”

“…Furino et al and Jonas et al adopted the same strategy without increased complications. 8,10 Tabandeh et al have advocated an injection 1 -2 weeks before the surgery; they will probably have the same protective effect, however, a combined intervention is probably less cumbersome for the patient as less visits have to be performed.…”

“…In an era in which exudative AMD can be treated successfully with anti-vascular endothelial growth factor (VEGF) drugs few studies have addressed cataract surgery in patients being treated with these agents. [7][8][9][10][11] It is important to understand the effect of cataract surgery and concomitant anti-VEGF therapy on exudative AMD.…”

“…Furino et al showed that in eyes with cataract and treatment naïve exudative AMD, a single injection of bevacizumab performed at the end of the surgery improved visual acuity and decreased retinal thickness one month after surgery. 10 The long-term effects of cataract surgery in patients with established CNV secondary to AMD that are being treated with intravitreal anti-VEGF therapy, have not been extensively studied. Rosenfeld et al showed, in a retrospective analysis of the MARINA and ANCHOR trials that eyes submitted to cataract surgery while on treatment with ranibizumab, increased visual acuity more than 10 ETDRS (Early Treatment Diabetic Retinopathy Study) letters.…”