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EW INTERNATIONAL 112 March 2017 by Stefanie Petrou Binder, MD, EyeWorld Contributing Writer excluded from the investigation. All the patients underwent a detailed eye exam, including best corrected visual acuity (BCVA) at all visits, fundus photography, and flu- orescein angiography when deemed necessary by the treating physician, and OCT at each visit. Cataract morphology was assessed and wet AMD characteristics were evaluated. Optical coherence tomography was implemented to identify subretinal fluid, intraretinal cysts, pigment epithelium detachment, and hemor- rhage. Fluorescein angiography was applied to spot leakage and hemor- rhages. The study investigators calculat- ed and compared the number of in- travitreal applications of anti-VEGF prior to surgery, as well as the duration of the dry macula period before and after surgery. They mon- itored for the appearance of fluid recurrence following cataract surgery and grouped wet AMD patients from Group I with no fluid recurrence into Group IA, while those with flu- id recurrence comprised Group IB. After phacoemulsification and cataract surgery, there were six individuals from Group I with no fluid recurrence (Group IA, 20%), of which four patients had nucle- ar cataract (66.6%), and two had subcapsular cataract (44.4%). Fluid recurrence was noted in 13 patients (Group IB, 43.3%), of which 9 pa- tients had nuclear cataract (69.2%) and 4 had subcapsular cataract (30.7%). Going forward, Group IA continued to be monitored, and Group IB was treated with anti-VEGF drugs. In Group I, OCT revealed sub- retinal fluid in 11 patients (57.89%), intraretinal cysts in 8 (42.10%), pigment epithelium detachment in 18 (94.73%), and hemorrhage in 1 patient (2.26%). In Group II, subret- inal fluid was noted in two individ- uals (18.18%), intraretinal cysts in three (27.2%), pigment epithelium detachment in nine (81.8%), and hemorrhage in one patient (9.09%). "We carefully followed a small group of patients with cataract and wet AMD and saw that they demon- strated a high recurrence rate of wet AMD after cataract surgery in 68.4%. Pigment epithelium detachment was common in both groups, while the emergence of subretinal fluid and Sofia, Bulgaria. Dr. Vassileva looked at all consecutive patients from April 2015 to April 2016 at her hospital who had been treated for wet AMD intravitreally using VEGF drugs before undergoing phacoemulsifica- tion for cataract surgery, as well as patients with advanced cataract who were diagnosed with AMD at the time of cataract surgery, and subse- quently treated. "There is no clear consensus as to the appropriate time for cata- ract surgery in wet AMD patients or if it affects disease progression. Many patients ask questions like, 'Is decreased vision due mostly to wet AMD or to cataract progression?' and 'What is the best timing of surgery during wet AMD treatment in relation to disease activity?' So our purpose, based on what we fre- quently experience in our clinic, was to investigate the risk of wet AMD progression associated with phaco surgery in patients with both wet AMD and cataract, to assess the risk factors for disease reactivation, and understand more about how timing influences outcomes," Dr. Vasilleva Better visual outcomes after phacoemulsification noted in wet AMD patients with more frequent injec- tions and longer exuda- tion-free periods A new study that investi- gated the relevance of timing in patients with wet age-related macular degeneration (AMD) and concomitant cataract has demon- strated that the greater the number of anti-vascular endothelial growth factor (VEGF) injections before cata- ract surgery, the lower the incidence of fluid recurrence postoperatively. The study also revealed that a longer dry macula period prior to cataract surgery was often followed by a lower incidence of fluid recurrence and a longer dry macula period after surgery. The retrospective medical record review was conducted by Petja Vas- sileva, MD, University Eye Hospital, Timing cataract surgery around anti-VEGF injections may be a good idea Presentation spotlight said during a video presentation of her investigation, held during last Septem- ber's XXXIV Congress of the European Society of Cataract and Refractive Surgery in Copenhagen, Denmark. The investigation included 30 patients with a mean age of 78 (range: 70–89 years), of which there were 14 female and 16 male patients. At base- line, the patients were divided into two groups. Group I had 19 subjects (63.3%) with wet AMD who under- went phacoemulsification for cataract surgery following treatments with in- travitreal anti-VEGF injections of bev- acizumab and/or aflibercept. Group II included 11 individuals (36.66%) with advanced stages of cataract whose AMD was diagnosed and treated after cataract surgery. The inclusion criteria were patients with wet AMD of different severities, patients who had been treated with anti-VEGF drugs for wet AMD, and/or the presence of signif- icant cataract. Patients with diabetic retinopathy, diabetic macular edema, vitreoretinal surgery, retinal vascular occlusion, or any evidence of end- stage AMD or disciform scar were Coming in the April 2017 issue of EyeWorld ASCRS•ASOA program preview You've arranged transportation, booked housing, and made a list of things to do in LA. Now it's time to plan all the things to do during the main event— the 2017 ASCRS•ASOA Symposium & Congress. Exhibit Hall Preview • Exhibitor Index • Product Showcase Specialty Days Previews • Advocacy Day • Cornea Day • Glaucoma Day • Refractive Day Programming Previews • Binkhorst Lecture • Kelman Lecture • Session Previews • Sunday Summit Event Previews • Ophthalmic Photographers' Society • Run for Sight • Film Festival … and much more!

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