Abstract:
Background: To evaluate functional and anatomical outcomesof cataract surgery in neovascular age-related macular neovascularization (nAMD) eyes receiving anti-vascular endothelial growth factor (anti-VEGF) intravitreal injections in modified pro re nata (PRN) regimen. Materials and Methods: Sixty eyes of 60 nAMD patients, including 41 women (68.3%) and 19 men (31.7%) in an average age of 77.35 ± 6.41 years, under treatment with intravitreal aflibercept injections in modified PRN regimen with no signs of macular neovascularization (MNV) activity during two consecutive visits were included in this prospective, observational study. Best-corrected visual acuity (BCVA), central retinal thickness (CRT), as well as the number of anti-VEGF injections were monitored six months before and after phacoemulsification with intraocular lens (IOL) implantation. Further, the change of the abovementioned parameters was assessed during the six-month follow-up period for CRT and the number of injections, while the BCVA was monitored for 54 months. Results: BCVA measured on the first day after surgery (0.17 ± 0.19 logMAR) as well as in the six-month post-surgery (0.13 ± 0.16 logMAR) significantly improved compared to preop values (0.42 ± 0.20 logMAR). BCVA remains stable during the observational period. We found that both differences were statistically significant (p < 0.01). The mean CRT and the mean number of injections did not differ between the six-month pre- and post-surgical periods. Conclusions: We showed the beneficial effect of phacoemulsification in nAMD patients treated with anti-VEGF agents on visual outcomes in the short and long term. Cataract surgery in nAMD eyes treated with anti-VEGF injections does not increase the frequency of anti-VEGF injections and does not cause deterioration of the macular status.
摘要:
背景:评估接受抗血管内皮生长因子(抗VEGF)玻璃体内注射的新生血管性年龄相关性黄斑新生血管(nAMD)眼白内障手术的功能和解剖学结果。材料与方法:60例nAMD患者的60只眼,包括41名女性(68.3%)和19名男性(31.7%),平均年龄77.35±6.41岁,在改良PRN方案的玻璃体内注射阿柏西普治疗下,在连续两次访视期间无黄斑新生血管(MNV)活动征象,纳入本前瞻性研究,观察性研究。最佳矫正视力(BCVA),中央视网膜厚度(CRT),在超声乳化人工晶状体(IOL)植入术前和术后6个月监测抗VEGF注射次数.Further,在6个月随访期间对上述参数的变化进行评估,而BCVA监测了54个月。结果:与手术前值(0.42±0.20logMAR)相比,手术后第一天(0.17±0.19logMAR)和手术后六个月(0.13±0.16logMAR)测得的BCVA显着改善。BCVA在观察期间保持稳定。我们发现两种差异均具有统计学意义(p<0.01)。术前和术后六个月的平均CRT和平均注射次数没有差异。结论:我们显示了在短期和长期使用抗VEGF药物治疗的nAMD患者中,超声乳化术对视力结果的有益作用。用抗VEGF注射治疗的nAMD眼中的白内障手术不会增加抗VEGF注射的频率,也不会导致黄斑状态的恶化。