Research: HUYNH and COLLEAGUES,

Listed in Issue 221

Abstract

AGE-RELATED EYE DISEASE STUDY 2 RESEARCH GROUP HUYNH and COLLEAGUES, (1)Clinical Trials Branch, Division of Epidemiology and Clinical Applications, National Eye Institute, National Institutes of Health, Bethesda, Maryland. (2)EMMES Corporation, Rockville, Maryland. (3)Wilmer Eye Institute, The Johns Hopkins University School of Medicine, Baltimore, Maryland. (4)Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida. (5)Clinical Trials Branch, Division of Epidemiology and Clinical Applications, National Eye Institute, National Institutes of Health, Bethesda, Maryland. echew@nei.nih.gov evaluated visual acuity following cataract surgery in patients suffering from age-related macular degeneration (AMD).

Background

The study group sought to evaluate visual acuity outcomes after cataract surgery in persons with varying degrees of severity of age-related macular degeneration (AMD).

Methodology

Design: Cohort study. Participants: A total of 1232 eyes of 793 participants who underwent cataract surgery during the Age-Related Eye Disease Study 2, a prospective, multicenter, randomized controlled trial of nutritional supplements for treatment of AMD. Preoperative and postoperative characteristics of participants who underwent cataract extraction during the 5-year trial were analyzed. Both clinical data and standardized red-reflex lens and fundus photographs were obtained at baseline and annually. Photographs were graded by a centralized reading centre for cortical and posterior subcapsular lens opacities and for AMD severity. Cataract surgery was documented at annual study visits or by history during the 6-month telephone calls. Analyses were conducted using multivariate repeated-measures regression. Main Outcome Measures: Change in best-corrected visual acuity (BCVA) after cataract surgery compared with preoperative BCVA.

Results

Adjusting for age at time of surgery, gender, interval between preoperative and postoperative visits, and 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], 6.9-15.5), eyes with moderate AMD (n = 346) gained 11.1 letters (95% CI, 9.1-13.2), eyes with severe AMD (n = 462) gained 8.7 letters (95% CI, 6.7-10.7), eyes with noncentral geographic atrophy (n = 70) gained 8.9 letters (95% CI, 5.8-12.1), and eyes with advanced AMD (central geographic atrophy, neovascular disease, or both; n = 324) gained 6.8 letters (95% CI, 4.9-8.8). The visual acuity gain across all AMD severity groups was statistically significant from preoperative values (P < 0.0001).

Conclusion

Mean visual acuities improved significantly after cataract surgery across varying degrees of AMD severity.

References

Age-Related Eye Disease Study 2 Research Group, Huynh N(1), Nicholson BP(1), Agrón E(1), Clemons TE(2), Bressler SB(3), Rosenfeld PJ(4), Chew EY(5). Visual acuity after cataract surgery in patients with age-related macular degeneration: age-related eye disease study 2 report number 5. Ophthalmology. 121(6):1229-36. doi: 10.1016/j.ophtha.2013.12.035. Epub 2014 Mar 7. Jun 2014.

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