Neovascular AMD and Cataract: Treatment Strategies and Current Approaches

Neovascular age-related macular degeneration (AMD) and cataract are two of the leading causes of vision loss in elderly adults, and they frequently coexist. When they do, managing both conditions can be clinically challenging, especially when it comes to deciding the right time for cataract surgery. Neovascular AMD ocurrs result of the growth of abnormal blood vessels under the retina, which can leak and leads to scarring and rapid central vision loss. This review explores how to best approach cataract surgery in patients already receiving anti-VEGF therapy for AMD. Studies show that when AMD is stable, cataract surgery can safely be performed and often leads to meaningful improvements in visual acuity without worsening the underlying retinal disease. In fact, removing a cataract can help patients see the full benefit of their AMD treatment. However, history of multiple intravitreal injections may slightly increase the risk of surgical complications for example: posterior capsular rupture. Overall, current evidence suggests that cataract surgery shouldn’t be unnecessarily delayed in patients with significant lens opacity and stabilised AMD. With careful planning, coordinated anti-VEGF treatment, and close follow-up, these patients can benefit from surgery.