Rappoport Daniel, Goldberg Mordechai, Bukelman Amir, Katz Haya, Goldberg Lital, Pollack Ayala
Ophthalmology Department, Kaplan Medical Center, Rehovot, Israel.
Hadassah and Hebrew University Medical School, Jerusalem, Israel.
Harefuah. 2017 Feb;156(2):79-83.
Age-related macular degeneration (AMD) is the leading cause of blindness in the western world. The debate continues over the safety of cataract surgery in the setting of neovascular (wet) AMD. This retrospective review aims to describe our experience in treating patients with wet AMD, who underwent cataract surgery by phacoemulsification.
We prepared a retrospective chart review of patients treated in our clinic between the years 2006 - 2013.
Forty-two eyes of 38 patients were included. Visual acuity (VA) improved significantly 1 month after cataract removal, without a significant change in retinal thickness. Twenty-six patients (62%) needed anti-VEGF injections during follow-up after surgery within an average period of 6 months. In eyes that were dry preoperatively, the re-injection rate was lower than those that were still wet (56 % vs. 80%) and the time from surgery to the first injection was longer in dry eyes (7 months and 3 months, respectively). Eyes that were injected with anti-VEGF up to one week before surgery had greater improvement in VA immediately after surgery but the proportion of those receiving injections (78%) was greater and the time to first injection post-surgery was earlier (3 months) compared to eyes that received the last injection 6 months or more prior to surgery ( 53 % and - 7 months).
Cataract removal improves vision in wet AMD patients. It is of great importance to treat these patients and try to reach dry retina prior to surgery and a close followup is needed after surgery. In eyes that were more stable within 6 months before surgery and their retina was dry, the re-injection rate post surgery was lower and the time to first injection was longer.
年龄相关性黄斑变性（AMD）是西方世界失明的主要原因。关于新生血管性（湿性）AMD患者进行白内障手术的安全性的争论仍在继续。本回顾性研究旨在描述我们对接受超声乳化白内障手术的湿性AMD患者的治疗经验。
我们对2006年至2013年间在我们诊所接受治疗的患者进行了回顾性病历审查。
纳入了38例患者的42只眼。白内障摘除术后1个月视力显著提高，视网膜厚度无显著变化。26例患者（62%）在术后随访期间平均6个月内需注射抗VEGF。术前为干性的眼，再次注射率低于仍为湿性的眼（分别为56%和80%），干性眼从手术到首次注射的时间更长（分别为7个月和3个月）。术前1周内注射抗VEGF的眼术后立即视力改善更大，但与术前6个月或更长时间接受最后一次注射的眼相比，接受注射的比例更高（78%），术后首次注射时间更早（3个月）（53%和7个月）。
白内障摘除可改善湿性AMD患者的视力。治疗这些患者并在手术前尽量使视网膜达到干性状态非常重要，术后需要密切随访。术前6个月内病情更稳定且视网膜为干性的眼，术后再次注射率较低，首次注射时间较长。
