Timing of cataract surgery in patient with wet AMD

Session Details

Session Title: Cataract Surgery Special Cases

Session Date/Time: Monday 12/09/2016 | 08:00-10:30

Paper Time: 09:16

Venue: Auditorium C6

First Author: : P.Vassileva BULGARIA

Co Author(s): :    Y. Kirilova   I. Georgiev   A. Georgieva              

Abstract Details

Purpose:

To investigate the risk of fluid recurrence associated with phaco surgery in patients with co morbidity of wet AMD (wAMD) and cataract.

Setting:

Referral University Eye Hospital, Sofia, Bulgaria

Methods:

A retrospective medical records review of patients with wAMD who underwent cataract surgery during intravitreal anti-VEGF treatment (Avastin/ Aflibercept). All consecutive patients underwent detailed eye exams, OCT, FA, fundus photography at all visits before and after surgery. Time periods between AMD diagnosis and anti-VEGF treatment and dry macula period duration preoperatively were analyzed. Routine phaco surgery with foldable PCIOL was performed by one surgeon. Anti-VEGF treatment schedule and follow up regimen were individually determined. Development or absence of exudation recurrence post cataract surgery and associated risk factors were analyzed. Follow up period was at least 3 months after cataract surgery.

Results:

Treatment duration (average 4 months) and number of intravitreal injections (average 3) preoperatively varied significantly between the 30 studied patients. Average dry macula period preoperatively was 4 months. In all patients decision for surgery was taken depending on patients’ visual needs, lens opacities density and possibility to monitor macular changes. In 9 patients with ultimate eye early intervention was required with shorter dry eye period preoperatively. In 12 patients cataract surgery was performed in advanced lens opacities but after at least 1 intravitreal injection. All patients improved VA .Exudation was diagnosed in 5 patients during follow up.

Conclusions:

Cataract surgery in patients with wAMD and cataract was beneficial for all patients and should not be delayed for better quality of life and optimal monitoring of wAMD progression. The relative significance of different risk factors for recurrent exudation was evaluated. The importance of dry macula period duration and careful follow up was emphasized. We observed wide range of variations among the studied patients and complicated interrelations between different factors, associated with individual visual requirements and timing of surgery. Additionally, we encountered also compliance and financial limitations. A prospective study has been started with more standardized design and criteria.

Financial Disclosure:

NONE