Abstract
Purpose :
To compare rate of cataract surgery complications in patients with a history of intravitreal injections relative to those without a history of intravitreal injection.
Methods :
A retrospective cohort study was performed using the TriNetX (Cambridge, MA) aggregated electronic health records research network. Patients with at least one intravitreal injection within twenty years prior to cataract surgery were compared to a control group who had cataract surgery but did not have a history of intravitreal injection. Propensity score matching (PSM) was performed using baseline demographics (age, race, gender) and various systemic and ocular co-morbidities. Patients were excluded if they had a history of pars plana vitrectomy prior to cataract surgery. Rate of lensectomy and/or vitrectomy within 30 days of cataract surgery, as a proxy for cataract surgery complication, were compared.
Results :
Data from 60 health care organizations across the US Collaborative Network was available from TriNetX at the time of study. On initial query, of patients who did not have a history of vitrectomy prior to cataract surgery, 13,561 patients had a history of intravitreal injection versus 423,903 patients who did not. After PSM, the exposure group had 12,541 and control 12,549 patients, with respective mean (SD) age 67.4 (12.7) and 66.2 (12.7), race composition 66.7% and 64.4% white, and gender composition 54.8% and 53.8% female. There was a higher rate (RR 1.72; 95% CI, 1.23-2.41; risk difference 0.3%, p=0.0015) of cataract surgery complications, as proxied by lensectomy or vitrectomy within a month of cataract surgery, in the group with prior intravitreal injection (91/12,541 = 0.7%) relative to the control group (53/12,549 = 0.4%).
Conclusions :
Relative to matched controls, patients with a prior intravitreal injection had an increased rate of additional vitreoretinal operations shortly following cataract surgery. The results presented here agree with evidence from smaller studies, but demonstrate a much smaller magnitude of risk. These findings, which represent the largest study of this question to date, emphasize the need to account a prior history of intravitreal injections during surgical planning.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.