Phacoemulsification Surgery in Eyes with Neovascular Age-Related Macular Degeneration

Grixti, Andre; Papavasileiou, Evangelia; Cortis, Dominic; Kumar, Balakrishna Vineeth; Prasad, Somdutt

doi:10.1155/2014/417603

Cited by 25 publications

(28 citation statements)

References 29 publications

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“…It is known that neovascular AMD, can compromise in 90% of cases severely the vision (20/200 or worse) if left untreated [37], but with the advent of anti-vascular Endothelial Growth Factor (anti-VEGF) intravitreal injections as therapy in wet AMD has got stabilize (90%) or even improved vision (30%) in a large number of cases [38][39][40][41][42][43].…”

Section: Neovascular Amdmentioning

confidence: 99%

“…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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Section: Neovascular Amdmentioning

confidence: 99%

Section: Neovascular Amdmentioning

confidence: 99%

Section: Neovascular Amdmentioning

confidence: 99%

Section: Neovascular Amdmentioning

confidence: 99%

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Untitled

2016

OCR

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“…47 The most recent study published by Grixti et al on 30 eyes from 29 subjects with nAMD actively treated by anti-VEGF who underwent phacoemulsification demonstrated a gain in vision from 0.69 LogMAR preoperatively to 0.6 at final visit (p = 0.0011) and no increased need for injections over the time of follow-up (average 0.167/month) at six-month follow-up. 48 The authors were encouraged by the findings and advocated for future larger prospective studies with more stringent monitoring mechanisms using formal fluorescein angiography and optical coherence tomography imaging to monitor disease progression following cataract extraction.…”

Section: Case Seriesmentioning

confidence: 99%

The Impact of Cataract Surgery on AMD Development and Progression

Qian

Young

2014

Seminars in Ophthalmology

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Age-related macular degeneration (AMD) and cataract are two leading causes of visual impairment worldwide which often occur concurrently in the same patient. With more than 1.6 million cataract operations performed per year in the United States, many of which occur in the nearly 1.75 million individuals diagnosed with AMD, there is ample incentive to further explore the interaction between these two conditions. Notably, the role of cataract surgery on AMD development and progression is of particular interest. This review summarizes the major findings from literature focusing on the effect of cataract surgery on AMD.

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