Anaesthetic Management of Achilles Tendon Tenotomy in a 2-Year-Old Child with Goldenhar Syndrome Using Videolaryngoscopy-A Case Report

Abstract

Background: Cataract and age-related macular degeneration (AMD) are major causes of visual impairment in the elderly and often coexist. The role of cataract surgery in improving visual and functional outcomes in patients with AMD remains an area of clinical interest and debate.

Aim: To evaluate the outcomes of cataract surgery in patients with AMD with respect to visual acuity, quality of life, and disease progression.

Methods: A systematic review of 16 studies published between 2000 and 2024 was conducted using PubMed, MEDLINE, EMBASE, Cochrane Library, and Google Scholar. Eligible studies included randomized controlled trials and observational studies assessing visual outcomes, quality of life, and AMD progression after cataract surgery. Data were extracted and synthesized using random-effects models, with heterogeneity quantified using I² statistics.

Results: Across the 16 included studies, cataract surgery was associated with significant improvements in visual acuity (pooled SMD ≈ −0.17 logMAR) and vision-related quality of life (pooled SMD ≈ 0.50). Functional outcomes, including reading speed and contrast sensitivity, also improved consistently. No convincing evidence was found that cataract surgery accelerates AMD progression, particularly in patients receiving modern anti-VEGF therapy. However, heterogeneity among studies was high (I² > 70%), reflecting variations in study design, AMD stage, and outcome measures.

Conclusion: Cataract surgery in AMD patients results in clinically relevant improvements in visual function and quality of life without significantly increasing the risk of disease progression. Careful patient selection and counseling remain crucial, particularly in advanced AMD where postoperative visual gains may be limited.