Cataract Surgery Improves Vision in Patients With AMD

Yael Waknine

March 29, 2014

Cataract surgery boosts vision regardless of age-related macular degeneration (AMD) severity, according to a large clinical study published online March 11 in Ophthalmology.

The findings, derived from the Age-Related Eye Disease Study 2 (AREDS2) trial of nutritional supplements in AMD, may help sway clinicians concerned about potential deleterious effects on disease progression, according to Nancy Huynh, MD, from the Clinical Trials Branch, Division of Epidemiology and Clinical Applications, National Eye Institute, National Institutes of Health, Bethesda, Maryland, and other members of the AREDS2 Research Group Writing Committee.

"Although accelerated progression to AMD has been reported in population-based studies, our results indicate that cataract surgery is indeed not harmful in persons with AMD," coauthor Emily Y. Chew, MD, deputy director, Division of Epidemiology and Clinical Applications at the National Eye Institute, told Medscape Medical News.

"Cataract surgeons and retinal specialists can look to this very important study to advise patients to consider cataract surgery when appropriate," Damien Luviano, MD, explained to Medscape Medical News, emphasizing the importance of vision improvement in patient functionality and quality of life.

Dr. Luviano, who was not involved in the study, is an ophthalmologist and partner at Southeast Texas Medical Associates in Beaumont.

Acuity Improved by 6.8 to 11.2 Letters

Outcomes for 793 patients with 1232 cataracts revealed significant gains in best-corrected visual acuity (P < .0001), ranging from 6.8 letters in eyes with advanced AMD (95% confidence interval [CI], 4.9 - 8.8) to 11.2 letters in those with mild disease (95% CI, 6.9 - 15.5).

Eyes with moderate AMD gained 11.1 letters (95% CI, 9.1 - 13.2), whereas those with severe disease or noncentral geographic atrophy gained 8.7 letters (95% CI, 6.7 - 10.7) and 8.9 letters (95% CI, 5.8 - 12.1), respectively.

The authors note that the results are even better than those achieved in the original AREDS study, which they attribute to a lower mean visual acuity at baseline as well as technological advances in surgical techniques and the advent of anti-VEGF therapies as a treatment standard.

Dr. Chew and Dr. Luviano both noted the importance of continued postsurgical follow-up and monitoring because of the progressive nature of AMD as a disease.

These findings were originally presented at the Association for Research in Vision and Ophthalmology 2013 Annual Meeting in Seattle, Washington. The study was supported by Research to Prevent Blindness Inc and the National Eye Institute, National Institutes of Health, Bethesda, Maryland. One coauthor has reported acting as a consultant for GlaxoSmithKline and receiving financial support from the EMMES Corporation, the Jaeb Center, Allergan, Bausch & Lomb, Bayer Healthcare, Genentech, Lumenis Inc, Notal Vision Ltd, Novartis, Regeneron, Thrombogenics, and Sanofi-Aventis. Another coauthor has reported acting as a consultant for Oraya, Novartis, Chengdu Kanghong Biotech, Acucela, Thrombogenics, and Canon; receiving financial support from Carl Zeiss, Meditec, Alexion, Potentia, and GlaxoSmithKline; and lecturing for Carl Zeiss Meditec, Allergan, and Topcon. The other authors and Dr. Luviano have disclosed no relevant financial relationships.

Ophthalmology. Published online March 11, 2014. Abstract

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