Phacoemulsification in eyes with neovascular AMD treated with anti-VEGF injections

PURPOSE. To evaluate visual results of phacoemulsification in eyes with neovascular age-related macular degeneration (AMD) treated with anti-vascular endothelial growth factor (VEGF) intravitreal injections. METHODS. This retrospective noncomparative interventional case-series study assessed best-corrected visual acuity (BCVA) at 4 timepoints: 1) baseline, immediately before first anti-VEGF injection; 2) preoperative, immediately before phacoemulsification; 3) postoperative, 1 month after phacoemulsification; 4) endpoint, at the last visit. Anti-VEGF retreatment regimen was based only on optical coherence tomography. The median time between anti-VEGF injections was evaluated for the time period before and after phacoemulsification. RESULTS. Sixteen eyes of 16 patients were included. The median (range) baseline, preoperative, postoperative, and endpoint BCVA was 0.7 (0.3-1.3), 0.72 (0.4-1.3), 0.5 (0.05-1.0), and 0.36 (0.0-1.0) logMAR, respectively. Best-corrected visual acuity significantly improved after phacoemulsification (mean 3 logMAR lines) and remained stable during follow-up (median 14 months, range 7-28). There was no statistically significant difference in the median time interval between injections before phacoemulsification and after phacoemulsification. CONCLUSIONS. Phacoemulsification significantly improved BCVA in patients with choroidal neovascular AMD. This effect persisted during follow-up with no increased need for anti-VEGF injections to keep macula dry.