Risk of Posterior Capsule Rupture During Cataract Surgery in Eyes With Previous Intravitreal Injections

Shalchi, Zaid; Okada, Mali; Whiting, Chris; Hamilton, Robin

doi:10.1016/j.ajo.2017.02.006

Cited by 37 publications

(52 citation statements)

References 14 publications

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“…Lee et al 7 also found that the number of injections was associated with increased risk. This is in contrast to the findings of Shalchi et al 8 , who reported no association between the number of injections and the risk of complication.…”

Section: Discussioncontrasting

confidence: 99%

Risk Model for Intraoperative Complication during Cataract Surgery Based on Data from 900,000 Eyes – Previous Intravitreal Injection is a Risk Factor

Segerstad

2020

Preprint

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Background/AimsThe aim of this study was to develop a risk model for intraoperative complication during cataract surgery and to include previous intravitreal therapy in the model.MethodsThis retrospective register-based study covered patients reported to the Swedish National Cataract Register (SNCR) between Jan. 1, 2010 and Jun. 30, 2018. Odds ratios (OR) were used to quantify association strength of each variable with intraoperative complication. Data from the SNCR were cross referenced with the Swedish Macula Register (SMR) to include data on previous intravitreal therapy. Variables statistically significant in the univariate analyses (P <0.05) were included in a multivariate logistic regression model.ResultsThe inclusion criteria were met by 907,499 eyes. The overall rate of intraoperative complication was 0.86%. After cross referencing, 3,451 eyes were identified in the SMR as having undergone intravitreal therapy prior to cataract surgery. Variables significantly associated with intraoperative complication (P<0.05) were best corrected visual acuity ≥1.0 LogMAR (adjusted OR): 1.75), age ≥90 years (OR: 1.25), male sex (OR: 1.09), pseudoexfoliation (OR: 1.33), glaucoma (OR: 1.11), diabetic retinopathy (OR: 1.35), previous intravitreal therapy (OR: 1.45), surgeon’s experience <600 surgeries (OR: 2.77), use of rhexis hooks (OR: 6.14), blue staining (OR: 1.87), and mechanical pupil dilation (OR: 1.52).ConclusionThe risk model can be used in the preoperative setting to predict the probability of intraoperative complication, to facilitate planning of surgery, and improving patient communication. Patients who have undergone intravitreal therapy prior to cataract surgery have an increased risk of intraoperative complication during cataract surgery.

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Section: Discussioncontrasting

confidence: 99%

Risk Model for Intraoperative Complication during Cataract Surgery Based on Data from 900,000 Eyes – Previous Intravitreal Injection is a Risk Factor

Segerstad

2020

Preprint

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“…It would appear that within a large study, a finding of ≤2.0% would represent a realistic goal. 19 , 27 This however may not represent the true benchmark. More recently, Abell et al 3 described a rate of 0.18% in patients undergoing conventional surgery in a comparative cohort study between conventional and FLACS techniques, which remains the lowest published mark within PCC literature within studies with reasonable sample sizes.…”

Section: Discussionmentioning

confidence: 99%

“…For the purposes of this study, an “experienced surgeon” was defined as one who does >350 cases per year, as this number has been validated both in a public and private hospital settings. 9 , 27 Scott et al 14 indicated that all surgeons improved the PCC rate following conversion to FLACS surgery; however, results suggest that the surgeons performing the most annual procedures experienced the least improvement in PCC rates. Further analysis is required from additional cohorts; however, we believe that our results support the authors’ findings that consistency and volume serve to further reduce the risk of complications.…”

Section: Discussionmentioning

confidence: 99%

Posterior capsular complication rates with femtosecond laser-assisted cataract surgery: a consecutive comparative cohort and literature review

Levitz¹,

Reich²,

Hodge³

2018

OPTH

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PurposeThe aim of the study was to determine whether femtosecond-assisted laser cataract surgery (FLACS) reduces the posterior capsular complication (PCC) rate compared to manual cataract surgery when performed by an experienced surgeon.Patients and methodsWe reviewed 2,021 consecutive FLACS procedures between 1 June 2012 and 30 August 2017. All cases of posterior capsular rupture (PCR) with or without vitreous prolapse or zonular dialysis (ZD) that prevented an in-the-bag placement of the intraocular lens were included. Risk factors were noted and outcomes documented.ResultsSix eyes of 2,021 (0.3%) who underwent FLACS had either a PCR or ZD. One eye (0.25%) of 403 eyes that had manual cataract surgery had a PCR. There was no significant difference in outcomes. Risk factors included advanced age, dense nuclei, pseudoexfoliation and small pupil. Only a single case in the FLACS series may have been directly attributed to the FLACS procedure.ConclusionThis study provides evidence that there is no significant difference in the PCC rate between FLACS and manual cataract surgery in the hand of an experienced surgeon who performs >350 cases annually. This low rate of complications may be achieved by less experienced surgeons adopting FLACS.

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“…3 Visual acuity (VA) improvement after cataract surgery was less in patients with nAMD than in patients without retinal disease in the Age-Related Eye Disease Study. 4 A history of intravitreal injections (IVT) may be a risk factor for complications of cataract surgery, including intra-operative posterior capsule rupture 5 and postoperative endophthalmitis. 6 Cataract surgery may increase the risk of progression to choroidal neovascularization (CNV) in eyes with intermediate AMD; 7 it may also activate existing CNV through inflammatory mediators released at the time of surgery.…”

Section: Introductionmentioning

confidence: 99%

Outcomes and Predictive Factors After Cataract Surgery in Patients With Neovascular Age-related Macular Degeneration. The Fight Retinal Blindness! Project

Daïen

Nguyen

Morlet

et al. 2018

American Journal of Ophthalmology

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Risk of Posterior Capsule Rupture During Cataract Surgery in Eyes With Previous Intravitreal Injections

Cited by 37 publications

References 14 publications

Risk Model for Intraoperative Complication during Cataract Surgery Based on Data from 900,000 Eyes – Previous Intravitreal Injection is a Risk Factor

Risk Model for Intraoperative Complication during Cataract Surgery Based on Data from 900,000 Eyes – Previous Intravitreal Injection is a Risk Factor

Posterior capsular complication rates with femtosecond laser-assisted cataract surgery: a consecutive comparative cohort and literature review

Outcomes and Predictive Factors After Cataract Surgery in Patients With Neovascular Age-related Macular Degeneration. The Fight Retinal Blindness! Project

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