From the Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas (Siddiqui, Elhusseiny, Chauhan, Neuhouser, Sallam); Department of Ophthalmology, Faculty of Medicine, Assiut University, Assiut, Egypt (Soliman); Department of Ophthalmology and Visual Sciences, University Hospitals Eye Institute, Case Western Reserve University, Cleveland, Ohio (Soliman); Wolverhampton Eye Infirmary, Royal Wolverhampton Hospitals NHS Trust, Wolverhampton, United Kingdom (Yang).
J Cataract Refract Surg. 2024 Feb 1;50(2):140-145. doi: 10.1097/j.jcrs.0000000000001325.
To compare the rate of intraoperative complications and visual outcomes in patients with neovascular age-related macular degeneration (NvAMD) and control eyes without NvAMD undergoing phacoemulsification.
Multicenter study.
Retrospective, nonrandomized comparative study.
Eyes were classified based on the presence or absence of an NvAMD diagnosis. The main outcomes were (1) the rate of intraoperative complications, (2) the logMAR visual acuity (VA) at 4 to 12 weeks postoperatively in both groups, and (3) the reinjection rate of intravitreal antivascular endothelial growth factor after phacoemulsification.
Preoperative VA was worse in the NvAMD group (0.9 ± 0.5) compared with the reference group (0.6 ± 0.5). We observed no difference in the rate of posterior capsule rupture (PCR) (2.90% vs 2.77%; P = .889), dropped lens fragments (0.46% vs 0.29%; P = .618), or zonular dialysis (0.46% vs 0.58%, P = .749) between the 2 groups. Receiving ≥10 intravitreal injections before cataract surgery predicted the likelihood of PCR with an odds ratio of 2.86 (P = .027). Proportions of eyes achieving a visual gain of ≥0.3 logMAR (∼3 Snellen lines equivalent) was lower in NvAMD eyes (39.2% vs 63.7%; P < .0001). We observed 203 eyes (73%) in the active treatment group and 139 eyes (36%) in the inactive treatment group received >1 intravitreal injection after phacoemulsification (P < .0001).
The risk for PCR was higher for eyes receiving ≥10 intravitreal injections before phacoemulsification. Only 39% of eyes with NvAMD had visual improvement by ≥3 Snellen lines.
比较行超声乳化白内障吸除术的新生血管性年龄相关性黄斑变性（nAMD）患者眼和无 nAMD 的对照眼的术中并发症发生率和视力结果。
多中心研究。
回顾性、非随机对照研究。
根据是否存在 nAMD 诊断对眼进行分类。主要结局是：（1）两组术中并发症发生率；（2）两组术后 4 至 12 周时的 logMAR 视力（VA）；（3）超声乳化白内障吸除术后玻璃体腔内抗血管内皮生长因子的再注射率。
nAMD 组术前 VA 较差（0.9 ± 0.5），参考组为（0.6 ± 0.5）。两组后囊膜破裂（PCR）发生率（2.90% vs 2.77%；P =.889）、落下的晶状体碎片（0.46% vs 0.29%；P =.618）或悬韧带离断（0.46% vs 0.58%，P =.749）无差异。白内障术前接受≥10 次玻璃体腔内注射与 PCR 的可能性相关，优势比为 2.86（P =.027）。nAMD 眼获得≥0.3 logMAR（~3 个 Snellen 线等效）视力提高的眼比例较低（39.2% vs 63.7%；P <.0001）。在活跃治疗组中观察到 203 只眼（73%），在非活跃治疗组中观察到 139 只眼（36%）在超声乳化白内障吸除术后接受了>1 次玻璃体腔内注射（P <.0001）。
在接受超声乳化白内障吸除术前接受≥10 次玻璃体腔内注射的眼，PCR 的风险更高。只有 39%的 nAMD 眼视力提高≥3 个 Snellen 线。
