January-February 2020

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The risk of posterior capsule rupture during phacoemulsification cataract surgery in eyes with previous intravitreal anti-vascular endothelial growth factor injections


by Anindyt Nagar, MBBS, Joshua Luis, MBBS, Nimrath Kainth, Georgios Panos, MD(Res), Cordelia Mckechnie, MBBS, Sudeshna Patra, MBBS

J Cataract Refract Surg. 2020;46(2). Article in press.

• Purpose: To investigate if previous intravitreal anti-vascular endothelial growth factor (VEGF) injections are a predictor for posterior capsule rupture (PCR) during phacoemulsification cataract surgery.

• Setting: National Health Service: Whipps Cross University Hospital Eye Treatment Centre. District General, London, United Kingdom

• Design: Single center, retrospective, electronic medical record (EMR) database study with univariate analysis.

• Methods: EMR (Medisoft) was used to extract data for eyes undergoing phacoemulsification surgery between 01.08.16 and 01.01.18. Patient demographics, indication for intravitreal therapy, treatment type, number of previous intravitreal injections (IVI), diabetic status, surgeon grade and operative complications were included as variables for analysis.

• Results: Data was available for 4047 cataract operations. Of these, 108 had undergone previous anti-VEGF IVI treatment. Three eyes were noted to have preoperative PC trauma and were excluded from the final analysis. The logistic regression analysis after exclusion of the eyes with pre-existing damage to the PC confirmed that prior anti-VEGF IVI treatment was associated with an increased risk of PCR when compared to the non-IVI group (9.26% vs 1.88%, p<0.0001). There is a dose dependent relationship between the number of anti-VEGF injections and the likelihood of PCR.

• Conclusions: Previous intravitreal anti-VEGF injections are significantly correlated with an increased risk of surgical PCR despite the absence of visible structural damage to the PC preoperatively.

The risk of posterior capsule rupture during phacoemulsification cataract surgery in eyes with previous intravitreal anti-vascular endothelial growth factor injections The risk of posterior capsule rupture during phacoemulsification cataract surgery in eyes with previous
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2020-01-13T12:59:25Z
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