Although many surgeons are hesitant to perform cataract surgery in patients with wet age-related macular degeneration, new data suggests the procedure is safe and provides good visual outcomes.

To reach this conclusion, researchers at the Mayo Clinic in Rochester, MN, studied 81 eyes that underwent cataract surgery and had received at least one intravitreal anti-vascular endothelial growth factor (VEGF) injection within six months of surgery. They used optical coherence tomography (OCT) to determine if macular fluid prior to cataract surgery “adversely affected vision or anatomic outcomes after cataract surgery in patients with exudative AMD.”

Results show significant improvement between pre- and postoperative best-corrected visual acuity (BCVA) when comparing all patients. Central subfield thickness (CST) showed no significant difference before and after surgery. Those with macular fluid pre-op (23 eyes) had no difference in final BCVA or CST, and the researchers noted no changes to their fluid levels post-op, compared with patients without pre-op macular fluid—they also had significant improvement in BCVA post-surgery.

“In a real world setting, patients with both cataracts and wet AMD may safely undergo cataract surgery,” the study concludes. “Patients with stable pre-operative fluid on OCT should be considered for cataract surgery as these patients did well post-operatively with no worsening of their neovascular process.”

Starr MR, Mahr MA, Barkmeier AJ, et al. Outcomes of cataract surgery in patients with exudative age-related macular degeneration and macular fluid. Am J Ophthalmol. 2018 August 1;192:91-7. [Epub ahead of print].