Evaluation of the effects of phacoemulsification surgery in patients with wet age-related macular degeneration using optical coherence tomography angiography

Purpose To assess the impact of uncomplicated phacoemulsification surgery in patients with wet age-related macular degeneration (AMD) using optical coherence tomography-angiography (OCTA). Design Prospective study. Method The study included eyes from 44 patients diagnosed with AMD who underwent phacoemulsification surgery and 44 eyes from 44 patients without an indication for cataract surgery. Patients who had received anti-vascular endothelial growth factor therapy within the last six months were excluded. Best-corrected visual acuity measurements, optical coherence tomography, and OCTA were performed preoperatively and at postoperative months 1, 3, and 6. During the same sessions, choroidal neovascular membrane area was evaluated manually with OCTA. Results Throughout follow-up, no significant differences were observed between the surgical and control groups regarding membrane area (p > 0.05). However, the change in membrane area in the surgical group, measured as an increase of 0.17 +/- 0.14 mm(2), was statistically significant (p < 0.05). No significant difference was found between the two groups in terms of flow area (p > 0.05). Vessel density measurements in the superficial capillary plexus did not significantly differ between the groups (p > 0.05). At the six-month visit, a significant decrease was observed in small-caliber vessels (p < 0.05) within the surgical group, along with a significant increase in the perilesional halo (p < 0.05); however, no significant changes were noted in other activation criteria (p > 0.05). Conclusion Phacoemulsification was determined to induce changes in certain parameters of the choroidal neovascularization in patients with wet AMD. Therefore, the timing of surgical intervention should be carefully planned, considering patients' daily life activities.