# Cataract surgery in eyes with adult-onset foveomacular-vitelliform dystrophy

## TL;DR

This study shows that cataract surgery improves vision in patients with a rare eye condition called AFVD without causing major complications.

## Contribution

The study is the first to demonstrate the safety and efficacy of cataract surgery in patients with adult-onset foveomacular-vitelliform dystrophy.

## Key findings

- Cataract surgery significantly improved visual acuity in AFVD patients at one month and one year post-surgery.
- No new cases of choroidal neovascularization or retinal atrophy were observed in AFVD eyes during 12 months of follow-up.
- Visual improvement after surgery was similar in AFVD, none-NV AMD, and NVAMD groups.

## Abstract

To assess the outcomes and safety of cataract surgery in Adult-Onset Foveomacular-Vitelliform dystrophy (AFVD) patients.

This retrospective study analyzed eyes with AFVD that underwent cataract surgery in a tertiary center, comparing them with eyes affected by none and neovascular age-related macular degeneration (NVAMD). Data included demographics, best-corrected visual acuity LogMAR (VA), eye examination results, and optical coherence tomography (OCT) results. The primary outcome was improvement in VA. A secondary outcome was AFVD progression such as the development of choroidal neovascularization (CNV) or retinal atrophy.

The cohort included 83 eyes (18 with AFVD, 27 with none-NV AMD, and 38 with NVAMD). AFVD eyes showed significant improvement in VA±SD from pre-surgery (0.60 ± 0.34) to 1 month (0.23 ± 0.11; P < 0.0001) and 12 months post-operatively (0.26 ± 0.12; P < 0.0001). No cases of CNV or major AFVD progression changes were observed over 12 months of follow up. However, at last follow-up (62.20 ± 39.30 months) there was increased proportion of atrophic AFVD (44.40% compared to 5.50% at baseline; P = 0.10).

No difference was found comparing VA improvement one month after surgery of none-NV AMD, NVAMD and AFVD (AFVD = 0.37 ± 0.36, none-NV AMD = 0.47 ± 0.68, NVAMD = 0.28 ± 0.37; P = 0.29). In the none-NV AMD group, one eye developed CNV ten months post-operatively and another eye demonstrated worsening retinal atrophy one-month post-surgery. In the NVAMD group, 9 eyes developed retinal atrophy at last follow up.

Cataract surgery in AFVD eyes led to significant visual acuity improvement and demonstrated good safety with no new CNV or retinal atrophy. The similar visual improvement across the AFVD, none-NV AMD and NVAMD groups suggests the procedure’s efficacy and safety for AFVD patients.

The online version contains supplementary material available at 10.1007/s00417-025-07018-x.

Studies on Age-related macular degeneration (AMD) indicate minimal progression post-cataract surgery.However, the safety of cataract surgery in patients with coexisting Adult-onset foveal-macular vitelliform dystrophy (AFVD) remain unexplored.

Studies on Age-related macular degeneration (AMD) indicate minimal progression post-cataract surgery.

However, the safety of cataract surgery in patients with coexisting Adult-onset foveal-macular vitelliform dystrophy (AFVD) remain unexplored.

The study reports on the outcomes of cataract surgery in AVFD eyes.Significant visual acuity improvements were seen with no significant complications, demonstrating good safety and efficacy of cataract surgery in AFVD eyes.

The study reports on the outcomes of cataract surgery in AVFD eyes.

Significant visual acuity improvements were seen with no significant complications, demonstrating good safety and efficacy of cataract surgery in AFVD eyes.

The online version contains supplementary material available at 10.1007/s00417-025-07018-x.