Combined intravitreal bevacizumab with phacoemulsification in visually significant cataract and visually significant exudative maculopathy

PURPOSE: We investigated the visual outcome of combined phacoemulsification with intravitreal bevacizumab, in eyes with dense cataract and visually significant exudative maculopathy. MATERIALS AND METHODS: Prospective longitudinal pilot study of consecutive patients treated by two surgeons in 2006, using intravitreal bevacizumab at the end of phacoemulsification. The historical control group consisted of consecutive subjects with exudative maculopathy and dense cataract treated by the same surgeons with the help of phacoemulsification without intravitreal bevacizumab prior to 2006. RESULTS: Thirty-one treated patients had the mean (SD) logMar best corrected visual acuity improving from - 1.48 (0.50) preoperatively to - 0.67 (0.38) in the first postoperative week (P < 0.001), to - 0.64 (0.40) in the first postoperative month (P < 0.001), and to - 0.62 (0.42) (P < 0.001) on the last follow-up (mean 4.2 months, range 1 – 9 months). Fourteen control patients had the mean (SD) logMar best corrected visual acuity improving from - 1.78 (0.79) preoperatively, to - 0.91 (0.53) in the first postoperative week (P < 0.001), to - 0.86 (0.45) in the first postoperative month (P < 0.001), and to - 0.90 (0.47) (P < 0.001) on the last follow- up (mean 19.6 months, range 1 – 49 months). Initial visual acuities, final visual acuities, and percentage of visual improvement at one month were all not significantly better in the intervention compared to the control group at one month. In the study group, the fovea was flattened at the one-month follow-up, by 90-diopter slit lamp examination and / or Optical coherence tomography. CONCLUSION: The combination of intravitreal bevacizumab and phacoemulsification is beneficial for maximal visual rehabilitation in the first postoperative month.