Visual Acuity Following Cataract Surgery in Patients with AMD
The authors of this cohort study evaluated visual acuity outcomes after cataract surgery in persons with varying degrees of severity of age-related macular degeneration.
They included 1,232 eyes of 793 participants who underwent cataract surgery during the prospective, multicenter, randomized controlled Age-Related Eye Disease Study 2 of nutritional supplements for treatment of AMD.
The authors analyzed the pre- and postoperative characteristics of participants who underwent cataract extraction during the five-year trial and obtained both clinical data and standardized red-reflex lens and fundus photographs at baseline and annually. Photographs were graded by a centralized reading center for cortical and posterior subcapsular lens opacities and for AMD severity. Additionally, cataract surgery was documented at annual study visits or by history during the six-month telephone calls. Analyses were conducted using multivariate repeated-measures regression. Change in best-corrected visual acuity following cataract surgery compared with preoperative BCVA was the main outcome measure.
Adjusting for age at time of surgery, gender, interval between preoperative and postoperative visits, as well as type and severity of cataract, the mean changes in visual acuity were as follows: eyes with mild AMD (n=30) gained 11.2 letters (95% confidence interval [CI], 6.9 to 15.5); eyes with moderate AMD (n=346) gained 11.1 letters (95% CI, 9.1 to 13.2); eyes with severe AMD (n=462) gained 8.7 letters (95% CI, 6.7 to 10.7); eyes with noncentral geographic atrophy (n=70) gained 8.9 letters (95% CI, 5.8 to 12.1); and eyes with advanced AMD (central geographic atrophy, neovascular disease or both; n=324) gained 6.8 letters (95% CI, 4.9 to 8.8). The visual acuity gain across all AMD severity groups was statistically significant from preoperative values (p<0.0001), the authors reported.
They determined that mean visual acuities improved significantly after cataract surgery across varying degrees of AMD severity.