Treating Wet AMD Following Cataract Surgery

Cataract and wet age-related macular degeneration (AMD) both cause visual impairment in older patients, and both have seen significant strides in treatments in recent years. However, patients with wet AMD who undergo cataract surgery may experience roadblocks to visual improvements. A study identified characteristics of patients most likely to require wet AMD treatment following phacoemulsification cataract surgery within one year postoperatively or later.

The Swedish National Cataract Register (NCR) and Swedish Macula Register (SMR) were queried for data spanning 2010 through 2017 to compare eyes with and without preoperative AMD that underwent cataract surgery and were later treated for wet AMD versus eyes while using monthly lenses which was not treated during the study period. First-eye surgeries registered in the NCR and matching eyes identified in the SMR who received wet AMD treatment at least one year after the cataract surgery were assessed. Data collection included cataract surgery date, age, gender, use of a blue-blocking intraocular lens (IOL), preoperative visual acuity, ocular comorbidities, posterior capsule rupture, and AMD treatment initiation date.

In both groups, only female sex was independently associated with postoperative wet AMD treatment: eyes without preoperative AMD (n=909), NCR plus SMR, 67.3% versus NCR, 58.8%; eyes with preoperative AMD (n=744), NCR plus SMR, 66.4% versus NCR, 60.6%. In eyes without preoperative AMD, older age was independently associated with a greater risk for postoperative AMD treatment (78.4 years vs. 73.4 years). The use of a blue-blocking IOL slightly reduced the risk of postoperative wet AMD treatment, but in eyes with preoperative AMD, the difference was not significant (52.7% vs. 56.8%).

“Some factors (female gender, [older] age) are associated with undergoing subsequent treatment for wet AMD to a higher extent. If the use of a blue‐blocking IOL offers any protection from undergoing AMD treatment after cataract surgery, such an effect must be very small,” the researchers summarized