Mehta Hemal
Save Sight Registries, University of Sydney, Sydney, NSW 2000, Australia.
Strathfield Retina Clinic, Strathfield, Sydney, NSW 2135, Australia.
J Clin Med. 2021 Jun 8;10(12):2538. doi: 10.3390/jcm10122538.
Cataract and age-related macular degeneration (AMD) are two of the most common eye diseases of aging. This review addresses the pre-operative, intra-operative, and post-operative considerations in managing cataract in patients with age-related macular degeneration. Surgery for visually significant cataracts in patients with AMD can substantially improve the quality of life and reduce the risk of falls. Pre-operative optical coherence tomography is now recommended where possible to identify pre-existing macula disease. Careful counselling of patients is required before cataract surgery, especially with respect to the expected visual outcome, intraocular lens choice and potential risks of surgery. Real-world data has suggested 6 months of intravitreal anti-VEGF therapy for neovascular AMD before cataract surgery is compatible with optimum long-term visual outcomes. Patients receiving intravitreal therapy for neovascular AMD should be advised of the slightly higher risk of intraoperative complications and the surgeon should be prepared to manage these during the operation. During cataract surgery, unnecessary light exposure should be avoided to reduce phototoxicity. Careful planning of intravitreal therapy for neovascular AMD just before cataract surgery allows the eye greater recovery time in the post-operative period before further planned intravitreal therapy.
白内障和年龄相关性黄斑变性（AMD）是两种最常见的老年性眼病。本综述探讨了年龄相关性黄斑变性患者白内障治疗中的术前、术中和术后注意事项。对AMD患者有视觉意义的白内障进行手术可显著改善生活质量并降低跌倒风险。现在建议尽可能进行术前光学相干断层扫描以识别已存在的黄斑疾病。白内障手术前需要对患者进行仔细的咨询，特别是关于预期的视觉效果、人工晶状体的选择和手术的潜在风险。真实世界的数据表明，白内障手术前对新生血管性AMD进行6个月的玻璃体内抗VEGF治疗与最佳的长期视觉效果相兼容。接受玻璃体内治疗新生血管性AMD的患者应被告知术中并发症风险略高，并且外科医生应准备好在手术期间处理这些并发症。在白内障手术期间，应避免不必要的光照以减少光毒性。在白内障手术前仔细规划新生血管性AMD的玻璃体内治疗，可使眼睛在术后有更长的恢复时间，以便进行进一步计划的玻璃体内治疗。
