Kaplan Medical Center, Israel
Prof. Ayala Pollack is a Professor and Chairperson of the Ophthalmology Department at Kaplan Medical Center. She graduated from the Sackler School of Medicine, Tel Aviv University with the honour of distinction and award for excellent thesis. During Medical school she started basic science research in the Department of Embryology and Teratology, Sackler School of Medicine, Tel Aviv University, She completed training in Ophthalmology Kaplan Medical Center and in the Department of Ophthalmology, Rothschild Hospital, Haifa, Israel affiliated to the Technion-Israel Institute of Technology.
Purpose: To evaluate the course of wet AMD in eyes undergoing phacoemulsification and previously treated with anti-VEGF injections. Methods: Records of patients ≥50 years with AMD who underwent uneventful phacoemulsification and had completed a minimum of 6 months follow-up (F-U) after surgery were retrospectively reviewed. Patients with complicated surgery and incomplete data were excluded. Data recorded were best corrected visual acuity (VA), fundoscopy and OCT at beginning of F-U, prior to surgery, 1 month after surgery and at the end of F-U. Also recorded were number and timing of injections before and after surgery. Results: Included were 42 eyes of 38 patients with wet AMD receiving intravitreal anti-VEGF injections prior to surgery. VA improved significantly 1 month postoperatively, without a significant change in retinal thickness. Thirty two (76%) were “dry” and 10 (24%) were still “wet” just before surgery. Twenty six patients (62%) needed anti-VEGF injections during follow-up after surgery within average of 6 months. In eyes that were "dry" preoperatively the re-injection rate was lower than those that were still "wet" (56% vs. 80% respectively). The average time from surgery to the first injection was longer in preoperative "dry" than in "wet" eyes (7 and 3 months, respectively). Conclusions: In this study, cataract removal improves vision in wet AMD patients. In eyes that were stable within 6 months before surgery and their retina was dry preoperativly, the re-injection rate post surgery was lower and the time to first injection was longer as compared to those that were "wet" preoperatively. We suggest to consider drying the retina prior to surgery and to follow them closely postoperatively.