First-Year Outcomes of Cataract Surgery Combined with Intravitreal Ranibizumab Injection in Wet Age-Related Macular Degeneration

Abstract

Objectives: To compare the first-year results of patients with active neovascular age-related macular degeneration (nAMD) under intravitreal ranibizumab (IVR) treatment who did and did not undergo cataract surgery. Materials and Methods: The records of 72 patients with active nAMD were reviewed retrospectively. Group 1 consisted of 23 patients who underwent uncomplicated cataract surgery and continued with IVR treatment and group 2 consisted of 49 patients without cataract who received only IVR treatment. The groups were compared according to pretreatment and first year best spectacle-corrected visual acuity (BCVA), central foveal thickness (CFT), number of injections, and nAMD activity (presence of subretinal or intraretinal fluid). Logarithm of minimum angle of resolution (LogMAR) was used for the determination of visual acuity. Activity findings were evaluated with optical coherence tomography. Results: Pretreatment BCVA was 0.94 +/- 0.21 in group 1 and 0.77 +/- 0.36 in group 2 (p=0.041). At the end of the first year, BCVA was 0.48 +/- 0.35 in group 1 and 0.49 +/- 0.33 in group 2 (p=0.902). BCVA change was 0.46 +/- 0.29 in group 1 and 0.28 +/- 0.31 in group 2 (p=0.026). Pretreatment CFT was 305 +/- 146 mu m in group 1 and 340 +/- 120 mu m in group 2 (p=0.292). At the end of the first year, CFT was 246 +/- 110 mu m and 245 +/- 82 mu m in group 2 (p=0.977). CFT change was 59 +/- 45 mu m in group 1 and 92 +/- 97 mu m in group 2 (p=0.135). Mean number of injections over 1 year was 6.2 +/- 1.9 in group 1 and 5.7 +/- 1.8 in group 2 (p=0.271). At the end of the first year, subretinal fluid was observed in 3 patients in group 1 (13%) and 5 patients in group 2 (10.2%) (p=0.721) and intraretinal fluid was present in 3 patients in group 1 (13%) and 4 patients in group 2 (8.2%) (p=0.515). Conclusion: Cataract surgery combined with IVR treatment yielded significant visual gain in patients with active nAMD. Anatomic results suggest that cataract surgery does not worsen nAMD.