Visual acuity dynamics after phacoemulsification in patients with “wet” form of age-related macular degeneration, treated by intravitreal angiogenesis inhibitor injections

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Abstract


Design: prospective non-randomized experimental longitudinal cohort study. The aim of the study: to evaluate the visual acuity after phacoemulsification in patients with the “wet” form of age-related macular degeneration, treated by intravitreal angiogenesis inhibitor injections. Materials: 48 patients (48 eyes) with the “wet” form of AMD, treated by intravitreal angiogenesis inhibitor injections, and incipient cataract. All eyes in the study had a diagnosis of “wet” AMD and underwent cataract surgery. They were followed for a minimum of two years after the cataract surgery. The mean age of patients was 78.16 ± 5 years. There were 36 female (75 %) and 12 male (25 %) patients. Results: All patients were retrospectively divided into two groups. Group No. 1 consisted of 23 patients — operated within a year of the diagnosis of “wet” AMD, and group No. 2 which consisted of 25 patients who had a diagnosis of “wet” AMD for longer than one year prior to the cataract surgery. The mean preoperative visual acuity in the 1st group was 0.16 ± 0.07 (median 0.15), and in patients of group 2 — 0.23 ± 0.06 (median 0,2). Mean visual acuity immediately before surgery in the 1st group was 0.13 ± 0.04 (median 0.09), in the 2nd group — 0.12 ± 0.04 (median 0,08). After surgery, in the 1st group, mean visual acuity was — 0.28 ± 0.08 (median 0.25), in the 2nd group —0.18 ± 0.07 (median 0,15). The difference between the two groups was statistically significant, p < 0.01, t-test. Statistically significant visual acuity increase after surgery was registered in both groups and was preserved after one and two years, when compared to the data before surgery: for the 1st group — 0.13 and 0.1; for the 2nd group — 0,1 and 0.07, respectively (p < 0,01, Wilcoxon criterion). Conclusions: Phacoemulsification is reasonable for eyes with the “wet” form of age-related macular degeneration. Patients with shorter “wet” AMD duration obtain a higher visual acuity increase after cataract surgery. Statistically significant visual acuity increase after surgery is preserved in the majority of patients during next 2 years of follow-up.

Natalya Viktorovna Chistyakova

I. P. Pavlov State Medical University

Email: nchistik@mail.ru
Department of Ophthalmology

Yuriy Sergeevich Astakhov

I. P. Pavlov State Medical University

Email: astakhov@spmu.rssi.ru
doctor of medical science, professor, head of the department of ophthalmology

Nikita Yuryevich Dal

I. P. Pavlov State Medical University

Email: nchistik@mail.ru
candidate of medical science, assistant professor, Department of Ophthalmology

  1. Age-Related Eye Disease Study Research Group. Responsiveness of the National Eye Institute Visual Function Questionnaire to progression to advanced age-related macular degeneration, vision loss, and lens opacity: AREDS report no. 14. // Arch. Ophthalmol. — 2005. — Vol. 123. — P. 1207–1214.
  2. Age-Related Eye Disease Study Research Group. Visual Acuity Outcomes after Cataract Surgery in Patients with Age-Related Macular Degeneration: AREDS report no. 27. // Ophthalmology. — 2009. — Vol. 116. — P. 2093–2100.
  3. Armbrecht A. M., Findlay C., Kaushal S. et al. Is cataract surgery justified in patients with age related macular degeneration? A visual function and quality of life assessment.// Br. J. Ophthalmol. — 2000. — Vol. 84. — P. 1343–1348.
  4. Baratz K. H., Gray D. T., Hodge D. O. et al. Cataract extraction rates in Olmsted County, Minnesota, 1980 through 1994. // Arch. Ophthalmol. — 1997. — Vol. 115. — P. 1441–1446.
  5. Busbee B. G., Brown M. M., Brown G. C., Sharma S. Incremental cost-effectiveness of initial cataract surgery. // Ophthalmology. — 2002. — Vol. 109. — P. 606–612; discussion 612–613.
  6. Chandrasekaran S., Wang J. J., Rochtchina E., Mitchell P. Change in health-related quality of life after cataract surgery in a population-based sample. // Eye. — 2008. — Vol. 22. — P. 479–484.
  7. De Jong P. T., Lubsen J. The standard gamble between cataract extraction and AMD. // Graefes Arch. Clin. Exp. Ophthalmol. — 2004. — Vol. 242. — P. 103–105.
  8. Freeman E.E., Munoz B., West S.K. et al. Is there an association between cataract surgery and age-related macular degeneration? Data from three opulation-based studies. // Am. J. Ophthalmol. — 2003. — Vol. 135. — P. 849–856.
  9. Javitt J. C., Brenner M. H., Curbow B. et al. Outcomes of cataract surgery: improvement in visual acuity and subjective visual function after surgery in the first, second, and both eyes. // Arch. Ophthalmol. — 1993. — Vol. 111. — P. 686–691.
  10. Klein R., Klein B. E., Linton K. L. Prevalence of age-related maculopathy: the Beaver Dam Eye Study. // Ophthalmology. — 1992. — Vol. 99. — P. 933–943.
  11. Klein B. E., Klein R., Lee K. E. Incidence of age-related cataract over a 10-year interval: the Beaver Dam Eye Study. // Ophthalmology. — 2002. — Vol. 109. — P. 2052–2057.
  12. Klein R., Klein B. E., Knudtson M. D. et al. Fifteen-year cumulative incidence of age-related macular degeneration: the Beaver Dam Eye Study. // Ophthalmology. — 2007. — Vol. 114. — P. 253–62.
  13. Lamoureux E. L., Hooper C. Y., Lim L. et al. Impact of cataract surgery on quality of life in patients with early age-related macular degeneration. // Optom. Vis. Sci. — 2007. — Vol. 84. — P. 683–688.
  14. Liu I. Y., White L., LaCroix A. Z. The association of age-related macular degeneration and lens opacities in the aged. // Am. J. Public.Health. — 1989. — Vol. 79. — P. 765–769.
  15. Lundstrom M., Stenevi U., Thorburn W. Outcome of cataract surgery considering the preoperative situation: a study of possible predictors of the functional outcome. // Br. J. Ophthalmol. — 1999. — Vol. 83. — P. 1272–1276.
  16. Lundstrom M., Brege K.G., Floren I. et al. Cataract surgery and quality of life in patients with age related macular degeneration. // Br. J. Ophthalmol. — 2002. — Vol. 86. — P. 1330–1335.
  17. Lundqvist B., Monestam E. Longitudinal changes in subjective and objective visual function 5 years after cataract surgery: Clin Experiment Ophthalmol prospective population-based study. // J. Cataract. Refract. Surg. — 2006. — Vol. 32. — P. 1944–1950.
  18. Mallah M. K., Hart P. M., McClure M. et al. Improvements in measures of vision and self-reported visual function after cataract extraction in patients with late-stage age-related maculopathy. // Optom. Vis. Sci. — 2001. — Vol. 78. — P. 683–688.
  19. Rutkow I. M. Surgical operations in the United States: then (1983) and now (1994). // Arch. Surg. — 1997. — Vol. 132. — P. 983–990.
  20. Schein O. D., Steinberg E. P., Cassard S. D. et al. Predictors of outcome in patients who underwent cataract surgery. // Ophthalmology. — 1995. — Vol. 102. — P. 817–823.
  21. Shuttleworth G. N., Luhishi E. A., Harrad R. A. Do patients with age related maculopathy and cataract benefit from cataract surgery? // Br. J. Ophthalmol. — 1998. — Vol. 82. — P. 611–616.
  22. Tan A. G., Wang J. J., Rochtchina E. et al. Increase in cataract surgery prevalence from 1992–1994 to 1997–2000: analysis of two population cross-sections. // Clin. Experiment. Ophthalmol. — 2004. — Vol. 32. — P. 284–288.
  23. Wang J. J., Foran S., Mitchell P. Age-specific prevalence and causes of bilateral and unilateral visual impairment in older Australians: the Blue Mountains Eye Study. // Clin. Experimen. Ophthalmol. — 2000. — Vol. 28. — P. 268–273.
  24. Wang J. J., Klein R., Smith W. et al. Cataract surgery and the 5-year incidence of late-stage age-related maculopathy: pooled findings from the Beaver Dam and Blue Mountains eye studies. // Ophthalmology. — 2003. — Vol. 110. — P. 1960–1967.

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