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Zaid Shalchi, Robin D Hamilton; Is the risk of posterior capsular rupture higher in eyes with previous intravitreal injections?. Invest. Ophthalmol. Vis. Sci. 2016;57(12):No Pagination Specified. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
Intravitreal injections are now the gold standard for the treatment of many retinal pathologies. They are commonly performed in phakic patients but little is known about the safety profile of future cataract extraction. We wanted to investigate the risk of posterior capsular rupture (PCR) during cataract surgery in eyes with previous intravitreal injections (IVI).
The Moorfields Patient Administrative System (PAS) and OpenEyes databases were used to study all cataract surgery procedures undertaken between 1 January 2012 and 31 August 2015 in the Moorfields main and satellite sites. All eyes which had received at least one intravitreal anti-VEGF injection were included.
In total, 57,991 cataract surgery procedures were undertaken over the study period, of which 1,034 were in eyes with previous intravitreal injection(s). The rate of PCR was higher in eyes with previous IVI (1.45%) than in non-IVI eyes (0.86%, p=0.04). Anterior capsular tear rates were no different between the 2 groups (p=0.39). The mean number of previous injections was similar in both PCR (7.40) and non-PCR (6.89) groups (p=0.73). PCR rates were equally likely when surgery was performed under the Cataract or the Medical Retina service (p=0.84). Subgroup analysis revealed risk of PCR to be equal in eyes previously injected for age-related macular degeneration, diabetic retinopathy, retinal vein occlusion or pathological myopia (p>0.5).
Eyes with previous IVI have a higher risk of PCR. This is not affected by number of previous injections, indication for injections or the specialty undertaking the surgery.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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