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Michael J. Coleman, Jr., Mark McDermott; Complications of Phacoemulsification After Repeated Intravitreal Injections. Invest. Ophthalmol. Vis. Sci. 2012;53(14):6703.
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To determine whether an increasing number of intravitreal injections are associated with increased intra-operative complications during extracapsular cataract extraction via phacoemulsification.
A retrospective study of patients seen at the Kresge Eye Institute and Harper Surgery Center between January 2004 and April 2011. Billing codes were used to find patients who received intravitreal injections prior to extracapsular cataract extraction via phacoemulsification. The charts were reviewed to determine the number of intravitreal injections, past ocular history, pre-op and post-op visual acuity, and any complications during cataract extraction. Patients were excluded if they had a vitrectomy prior to cataract extraction, chronic recurrent uveitis, and complex cataract procedures that included synechiolysis, trabeculectomy or shunt placement. The number of reported complications was then compared to an age matched control group.
46 patients met the inclusion criteria. Three complications of posterior capsule rupture were reported with two of the patients requiring pars plana vitrectomy for posterior lens dislocation. In the control group of 200 patients, there were 4 complications of posterior capsule rupture. The complication rate in the intravitreal injection group was 6.5% compared to 0.5% of the control group. No correlation (p-value .3382) was found between intravitreal injections and risk for complications during cataract extraction, although the average number of injections in the group without complications was 2.6 injections as compared to 15 injections in the complication group.
No correlation was found between frequency of intraocular injection and risk of complications from extracapsular cataract extraction, however complications trended upward with higher injection numbers. A larger study with stratification of injection frequency is needed.
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