Phacoemulsification Does Not Induce Neovascular Age-Related Macular Degeneration

Baatz, H.; Darawsha, R.; Ackermann, Hanns; Scharioth, Gábor B.; Ortueta, Diego de; Pavlidis, Mitrofanis; Hattenbach, L.-O.

doi:10.1167/iovs.07-0557

Cited by 61 publications

(56 citation statements)

References 27 publications

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“…7 It has been recommended that indications for cataract surgery should be more stringent than at present, in particular for patients with signs indicating a high risk for progression to late AMD. On the other hand, some studies 3, [8][9][10] could not confirm such observations. Nevertheless, several studies 11,12 report sustained improvement in visual function after cataract surgery in patients with early AMD.…”

mentioning

confidence: 89%

Long-term visual outcome after cataract surgery: Comparison of healthy eyes and eyes with age-related macular degeneration

Mönestam

Lundqvist

2012

Journal of Cataract and Refractive Surgery

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confidence: 89%

Long-term visual outcome after cataract surgery: Comparison of healthy eyes and eyes with age-related macular degeneration

Mönestam

Lundqvist

2012

Journal of Cataract and Refractive Surgery

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“…58 Recent large studies including a report from the multi-centre Age-related Eye Diseases Study (AREDS), which included 8,050 eyes, have found no significant evidence to Complications of cataract surgery Chan, Mahroo and Spalton support this. 59,60 Some cases of neovascular age-related macular degeneration are amenable to timely treatment with anti-VEGF agents and therefore, accurate diagnosis is important, so that there is no delay in treatment. One report 61 found a high incidence of neovascular age-related macular degeneration at one week after cataract surgery, suggesting that this was present pre-operatively, but was missed due to lens opacity.…”

Section: Age-related Macular Degenerationmentioning

confidence: 99%

Complications of cataract surgery

Chan

Mahroo

Spalton

2010

Clinical and Experimental Optometry

137

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Modern cataract surgery is safe in more than 95 per cent of patients. In the small number of cases where a serious complication occurs, the most common is an intra-operative posterior capsular rupture. This can lead to vitreous loss or a dropped nucleus and can increase the risk of post-operative cystoid macular oedema or retinal detachment. Postoperatively, posterior capsular opacification is the most common complication and can be readily treated with a YAG capsulotomy. The most devastating complication is endophthalmitis, the rate of which is now significantly decreased through the use of intracameral antibiotics. As a clinician, the most important step is to assess the patient pre-operatively to predict higher risk individuals and to counsel them appropriately. In these patients, various pre-or intra-operative management steps can be taken in addition to routine phacoemulsification to optimise their visual outcome.

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“…More recently, studies published have not showed an increase in recurrence, number of injections or worsening of visual acuity when compared with non-operated eyes [15,16,[25][26][27][39][40][41][42][43][50][51][52][53][54][55][56]. However, Lee and cols.…”

Section: Neovascular Amdmentioning

confidence: 99%

“…The studies published about cataract surgery in patients with neovascular AMD are mainly retrospective, FAG was only performed as a diagnostic test and not on the follow-up; some of them without control group and with short periods of follow-up [15,16,[25][26][27][39][40][41][42][43][50][51][52][53][54][55]58]. In addition, the protocols used in the reported studies, were inhomogeneous (treat and extend, pro-re-nata and monthly injections), but none compared these protocols between them, or even between different anti-VEGF agents (bevacizumab, ranibizumab or aflibercept) [38,39,[41][42][43][52][53][54][55].…”

Section: Neovascular Amdmentioning

confidence: 99%

“…In addition, the protocols used in the reported studies, were inhomogeneous (treat and extend, pro-re-nata and monthly injections), but none compared these protocols between them, or even between different anti-VEGF agents (bevacizumab, ranibizumab or aflibercept) [38,39,[41][42][43][52][53][54][55]. Then, it is required prospective research of causality and not only epidemiological studies, with long periods of follow-up to clarify studies published until now concerning this issue.…”

Section: Neovascular Amdmentioning

confidence: 99%

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Untitled

2016

OCR

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Age-related cataracts are a worldwide cause of blindness in 10.8 million of people and 35.1 million were visually impaired in 2010, it means that cataract caused 33.4% of blindness and 18.5% of moderate to severe vision impairment [1]. Cataract prevalence increase as people age, by age 75, half of population have a cataract; by age 80, 70% of whites, 53% of Africans and 61% of Hispanics [1,2]. Cataract surgery is a successful procedure in the majority of cases (about 95%) [2]. Although, it is not free of complications, because of the surgical procedure itself or due to coexisting ocular pathology; for example, the global incidence of post surgical cystoid macular edema is about 1.17%, but it is 4-fold increase in eyes with diabetic retinopathy, 5.6-fold in epiretinal membrane and 30-fold in retinal Age related-Macular Degeneration (AMD) is an acquired condition of the retina that causes significant central visual impairment and legal blindness in elderly people [4,5]. In the United States, the prevalence of AMD for people older than 40 years is estimated at 9.2%, then it increases exponentially, reaching 22.8% after 75 years old [6,7]. Recently (2016) an incidence study selected by ethnicity in a population based in the United States was published, finding an overall incidence of 4.1% in Early AMD and 2.3% in late AMD, the white population is the most affected population by 5.3% and 4.1% respectively [3].Thus, cataract and AMD are both age-related conditions that share similar comorbidities (hereditary, cardiovascular risk, free radicals, tobacco, sun exposition, etc.) [5,[8][9][10][11][12]. It is difficult to demonstrate a correlation between cataract surgery and AMD progression or deterioration because of this close relationship. Also, cataract development itself could preclude visualization of posterior pole and prevent a correct diagnosis of AMD [13][14][15][16]. Despite this, concern still exists in ophthalmologists about the behavior of the AMD or the choroidal neovascularization in a patient undergoing cataract surgery.The possible relationship of AMD and cataract surgery was reviewed and discussed. A very extensive searching was made; we analyzed randomized and non-randomized control trials, prospective and clinical trials. We discuss separately each type of AMD following AREDS classification. Likewise, we have intended to extract some recommendations to follow in this complicated scenario according recently clinical evidence. Early-Intermediate AMD and Cataract SurgeryThere are at least four main studies concerning cataract surgery and AMD development, the Beaver Dam Study (BDS), Blue Mountains eye Study (BMS), Rotterdam Eye Study, Los Angeles Latino Eye Study (LALOS). They evaluated the incidence of early manifestations of AMD in patients without signs of AMD at baseline who were submitted to cataract surgery and they did not find a relationship with early AMD.However, there are numerous publications found a possible relationship and they have suggested mechanisms that could lead to progression in AMD ...

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Phacoemulsification Does Not Induce Neovascular Age-Related Macular Degeneration

Abstract: The results indicate that cataract surgery in eyes with early AMD is not a causative factor in neovascular AMD.

Cited by 61 publications

References 27 publications

Long-term visual outcome after cataract surgery: Comparison of healthy eyes and eyes with age-related macular degeneration

Long-term visual outcome after cataract surgery: Comparison of healthy eyes and eyes with age-related macular degeneration

Complications of cataract surgery

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