Patients with age-related macular degeneration (AMD) may have “transient” adverse macular changes after cataract surgery, usually resolving about six months later, according to a new study.
Study authors said cataract and AMD share age as a main risk factor and thus have a high coincidence, posing “complex management dilemmas for clinicians, particularly concerning the timing and outcomes of cataract surgery in AMD patients”. Another key issue is whether cataract surgery accelerates AMD progression.
The study… aimed to investigating cataract surgery in a well-documented and closely followed-up AMD population under real-world conditions
The study, published in Ophthalmology Retina,1 aimed to investigate cataract surgery in a well-documented and closely followed-up AMD population under real-world conditions.
“The study has two objectives. The first objective is to understand whether cataract surgery leads, under real-world conditions, to measurable effects on best-corrected VA (BCVA) despite the AMD-related damage to the macula.
“The second objective is to explore under clinical routine conditions whether cataract surgery changes the need for intravitreal injections in subjects with neovascular AMD,” the study authors said.
The data also show no postoperative change in anti-VEGF injections in patients with neovascular AMD.
A total of 418 eyes of 418 patients were included in the analysis, with a mean follow-up time of 18.8 months. They were classified into a neovascular AMD (n=85) and a dry AMD (n=333) cohort.
Mean BCVA improved significantly in the neovascular AMD cohort from 0.69 ± 0.45 logarithm of the minimum angle of resolution (logMAR) to 0.47±0.42 (P<0.001), and in the dry AMD cohort from 0.53±0.47 logMAR to 0.27±0.32 (P< 0.001) at the two-month follow-up. Improvements in BCVA were sustained to the final visit (18.8±19.5 months after surgery) with BCVA at 0.46±0.38 logMAR (P<0.001) and 0.26±0.34 logMAR (P<0.001), respectively. Temporary postoperative increases in central retinal thickness and macular volume were observed, reverting to preoperative levels by six months after surgery.
“Overall, the study suggests no adverse long-term macular changes attributable to cataract surgery,” the study authors concluded.
Reference
- Hössl L, Vaghefi SA, Zeitz O, et al. Insights into cataract surgery outcomes in age-related macular degeneration: Perspectives across severity grades under clinical routine conditions. Ophthalmol Retina. 2025 Jun;9(6):527-536. doi: 10.1016/j.oret.2024.11.018.
