Effect of Phacoemulsification on Visual Acuity and Macular Morphology in Patients with Wet Age-Related Macular Degeneration

Abstract

BackgroundThis article discusses the effectiveness of phacoemulsification cataract surgery with intraocular lens implantation in patients with wet age-related macular degeneration in the inactive phase of the disease.Material/MethodsForty-nine patients (50 eyes) aged 78.94±5.54 years, previously treated with intravitreal injections of anti-vascular endothelial growth factor agents, were qualified for a prospective, randomized 12-month study. The participants were divided into 2 groups. Group I consisted of 25 patients (25 eyes) who were subjected to phacoemulsification cataract surgery. Group II consisted of 24 patients (25 eyes) who were not subjected to phacoemulsification cataract surgery despite having a lens opacity of grade II or higher according to the Lens Opacities Classification System.ResultsAfter 12 months of follow-up, patients in group I gained on average 8.04 letters (p<0.001). Furthermore, 20% of the eyes had a significant improvement in best corrected visual acuity of ≥15 Early Treatment of Diabetic Retinopathy Study Chart letters. Patients in group II lost on average 1.96 letters (p>0.05). No significant differences between central retinal thickness values in either group (p>0.05) were noted. The mean number of intravitreal injections of anti-vascular endothelial growth factor agents during the study was 2.64±1.98 in group I and 2.92±2.40 in group II (p>0.05).ConclusionsPhacoemulsification performed in eyes with wet age-related macular degeneration during the inactive phase of the disease significantly improves visual acuity. In addition, it does not significantly influence the frequency of intravitreal injections of anti-vascular endothelial growth factor agents or disease activity.

An observational clinical study of the influence of phacoemulsification on choroidal neovascular membrane activity in age related macular degeneration

“…A number of methodologies have been applied to provide partial reassurance that phacoemulsification does not appear to have a substantial impact on CNV activity. Many are limited by the size of the cohorts studied, and hence the power to exclude a small effect [ 10 – 14 ]. Other larger studies have focused on the rate of CNV development following phacoemulsification on eyes with early AMD [ 15 , 16 ].…”

Features of Phacoemulsification in Macular Pathology. Part 1. Diagnostic Aspects

“…Помутнение хрусталика при дегенеративных заболеваниях центральной зоны сетчатки, в частности возрастной макулярной дегенерации (ВМД), в настоящее время является одной из наиболее распространенных офтальмологических патологий [1,2]. Патогенез катаракты является многофакторным и имеет много общих механизмов с ВМД [3], которая значительно ухудшает функциональные параметры, такие как острота зрения, и навсегда нарушает морфологию макулы [4].…”