Eyeworld

EW NEWS & OPINION 19 larger incision size and more iris ma- nipulation, ECCE and ICCE can be associated with more tissue trauma and blood aqueous barrier break- down, which may theoretically in- duce post-op inflammation acting as an additional angiogenic stimulus, thereby increasing the risk of CNV. 13- 14 In these circumstances, an eye with early AMD might be especially vulnerable to tissue trauma because of defective Bruch's membrane. 19 Hence, it might be inferred that pha- coemulsification has the advantage over ECCE or ICCE of decreasing the risk of post-op CNV development. 3, 6, 9, 19-20 Based on the situation that asso- ciated AMD with cataract, we recom- mend that cataract surgeons have a straightforward discussion with pa- tients explaining reduced visual po- tential after cataract surgery due to existing AMD or possible unrecog- nized CNV or geographic atrophy. Most importantly, clinicians should be aware that strong evidence sug- gests that phacoemulsification cataract surgery does not worsen AMD and is clearly beneficial to AMD patients in terms of visual function and quality of life. There- fore, cataract surgery should not be withheld from this population of pa- tients. EW References 1. Blair CJ, Ferguson J, Jr. Exacerbation of se- nile macular degeneration following cataract extraction. Am J Ophthalmol. 1979;87(1):77- 83. 2. Bockelbrink A, Roll S, Ruether K, Rasch A, Greiner W, Willich SN. Cataract surgery and the development or progression of age-related macular degeneration: a systematic review. Surv Ophthalmol. 2008;53(4):359-67. 3. Chew EY, Sperduto RD, Milton RC, Clemons TE, Gensler GR, Bressler SB, et al. Risk of ad- vanced age-related macular degeneration after cataract surgery in the Age-Related Eye Disease Study: AREDS report 25. Ophthalmol- ogy. 2009;116(2):297-303. PMCID: 3021282. 4. Casparis H, Lindsley K, Bressler NB. Surgery for cataracts in people with age-related mac- ular degeneration. Cochrane Database Syst Rev. 2009(1):CD006757. 5. Forooghian F, Agron E, Clemons TE, Ferris FL, 3rd, Chew EY. Visual acuity outcomes after cataract surgery in patients with age-related macular degeneration: age-related eye dis- ease study report no. 27. Ophthalmology. 2009;116(11):2093-100. PMCID: 3021463. 6. Dong LM, Stark WJ, Jefferys JL, Al-Hazzaa S, Bressler SB, Solomon SD, et al. Progression of age-related macular degeneration after cataract surgery. Arch Ophthalmol. 2009;127(11):1412-9. 7. Armbrecht AM, Findlay C, Aspinall PA, Hill AR, Dhillon B. Cataract surgery in patients with age-related macular degeneration: one- year outcomes. J Cataract Refract Surg. 2003;29(4):686-93. 8. Armbrecht AM, Findlay C, Kaushal S, Aspinall P, Hill AR, Dhillon B. Is cataract sur- gery justified in patients with age related macular degeneration? A visual function and quality of life assessment. Br J Ophthalmol. 2000;84(12):1343-8. PMCID: 1723362. 9. Hooper CY, Lamoureux EL, Lim L, Fraser- Bell S, Yeoh J, Harper CA, et al. Cataract sur- gery in high-risk age-related macular degeneration: a randomized controlled trial. Clin Experiment Ophthalmol. 2009;37(6):570- 6. 10. Lundstrom M, Brege KG, Floren I, Lundh B, Stenevi U, Thorburn W. Cataract surgery and quality of life in patients with age related macular degeneration. Br J Ophthalmol. 2002;86(12):1330-5. PMCID: 1771417. 11. Baatz H, Darawsha R, Scharioth G, De Ortueta D, Ackermann H. Visual acuity after cataract surgery in patients with age-related macular degeneration. Ophthalmologe. 2008;105(10):927-30. 12. Klein R, Klein BE, Wong TY, Tomany SC, Cruickshanks KJ. The association of cataract and cataract surgery with the long-term inci- dence of age-related maculopathy: the Beaver Dam eye study. Arch Ophthalmol. 2002;120(11):1551-8. 13. Pande MV, Spalton DJ, Kerr-Muir MG, Mar- shall J. Postoperative inflammatory response to phacoemulsification and extracapsular cataract surgery: aqueous flare and cells. J Cataract Re- fract Surg. 1996;22 Suppl 1:770-4. 14. Schmidt-Erfurth U, Schlotzer-Schrehard U, Cursiefen C, Michels S, Beckendorf A, Nau- mann GO. Influence of photodynamic therapy on expression of vascular endothelial growth factor (VEGF), VEGF receptor 3, and pigment epithelium-derived factor. Invest Ophthalmol Vis Sci. 2003;44(10):4473-80. 15. Klein R, Klein BE, Jensen SC, Cruickshanks KJ. The relationship of ocular factors to the inci- dence and progression of age-related macu- lopathy. Arch Ophthalmol. 1998;116(4):506-13. 16. Pollack A, Bukelman A, Zalish M, Leiba H, Oliver M. The course of age-related macular degeneration following bilateral cataract sur- gery. Ophthalmic Surg Lasers. 1998;29(4):286-94. 17. Wang JJ, Klein R, Smith W, Klein BE, Tomany S, Mitchell P. Cataract surgery and the 5-year incidence of late-stage age-related maculopathy: pooled findings from the Beaver Dam and Blue Mountains eye studies. Oph- thalmology. 2003;110(10):1960-7. 18. Ho L, Boekhoorn SS, Liana, van Duijn CM, Uitterlinden AG, Hofman A, et al. Cataract sur- gery and the risk of aging macula disorder: the Rotterdam study. Invest Ophthalmol Vis Sci. 2008;49(11):4795-800. 19. Baatz H, Darawsha R, Ackermann H, Scharioth GB, de Ortueta D, Pavlidis M, et al. Phacoemulsification does not induce neovas- cular age-related macular degeneration. In- Cataract surgery–macular degeneration: Reduced visual potential, unrecognized choroidal neovascularization The Maskin* Meibum Expressor ™ 3360 Scherer Drive, Suite B, St. Petersburg, FL 33716 s 4EL s &AX %MAIL )NFO 2HEIN-EDICALCOM s 7EBSITE WWW2HEIN-EDICALCOM **$EVELOPED )N #OORDINATION 7ITH 3TEVEN , -ASKIN -$ #OMPOSITE !RT /F 4HE $AVID 2APHAEL 3KETCH -ICHELANGELO 3CULPTURE AGBB 1318 Rev.A s 4HE %XPRESSOR )S $ESIGNED 4O 2EMOVE -EIBUM &ROM ,IDS 4O %XPRESS -EIBUM 3IMPLY !DVANCE 3QUEEZE &ROM 4HE $EEP ,ID 4O 4HE ,ID -ARGIN 4HE 2OLLERS )NCREASE 0RESSURE )N 4HE 4ARSAL 0LATE !DVANCING -EIBUM 4HROUGH 4HE /RIl CE s 4HE 3PECIAL $IAMOND +NURLING /N 4HE 2OLLERS 0REVENTS 3LIPPAGE %NABLES 4HE )NSTRUMENT 4O %NGAGE 2OLL !GAINST 4HE 3MOOTH #ONJUNCTIVA 7ITHOUT !BRADING 4HE -UCOSAL 3URFACE s 2EUSABLE !UTOCLAVEABLE -ADE )N 4HE 53! 'UARANTEED &OR ,IFE /FFERED &OR ! $AY 3URGICAL %VALUATION 7ITHOUT /BLIGATION )NSTRUCTIONAL 6IDEOS !RE !VAILABLE /NLINE !T WWW2HEIN-EDCALCOM #ONTACT 2HEIN -EDICAL !T &OR -ORE )NFORMATION 0 R O D U CT # 8 116 2 O LL E R S /P EN % XP RE S S I ON / F - E I BU M 2 O LL E R S # L O S ED #OME 3EE 5S !T %3#23 "OOTH " Maskin Expressor1319EWescrs.indd 1 7/14/11 11:27 AM September 2011 continued on page 20

• Cover