The Risk of Posterior Capsule Rupture during Phacoemulsification Cataract Surgery in Eyes with Previous Intravitreal Anti Vascular Endothelial Growth Factor Injections.

Nagar, Anindyt; Luis, Joshua; Kainth, Nimrath; Panos, Georgios D; Mckechnie, C; Patra, Sudeshna

doi:10.1097/j.jcrs.0000000000000047

Cited by 8 publications

(19 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Fan et al (1999) found around 7.6% of eyes with an axial length greater than 26 mm experienced PC rupture, while Zuberbuhler et al (2009) found lower rates of 2.8% of PC tears and 1.7% of zonular dehiscence, which was similar to eyes without greater axial lengths. We also found that a history of anti-VEGF injections was associated with PC tears but not zonulopathy which is consistent with prior studies (Lee et al 2016;Miller et al 2020;Nagar et al 2020). It is thought that inadvertent trauma to the lens capsule at the time injection may account for this association.…”

Section: Discussionsupporting

confidence: 91%

See 1 more Smart Citation

Prior pars plana vitrectomy and its association with adverse intraoperative events during cataract surgery

Mudie

Patnaik

Lynch

et al. 2021

Acta Ophthalmologica

View full text Add to dashboard Cite

Purpose: To evaluate the risk of intraoperative complications during cataract surgery in eyes with a prior vitrectomy. Methods: A retrospective review of data from our cataract surgery registry of all patients undergoing cataract surgery between 2014 and 2018 at the University of Colorado Hospital. Univariate and multivariate analyses were conducted, accounting for intra-patient correlation in subjects who underwent two cataract surgeries. The three main outcomes of interest, zonulopathy, posterior capsule (PC) tears and dropped lens fragments, were analysed for their association with prior pars plana vitrectomy (PPV) and clinical characteristics of patients such as history of prior intravitreal injection and surgeon level of experience. Results: 10 540 eyes of 6447 patients were included in the analysis. 371 (3.5%) eyes had a prior PPV. Eyes with a prior PPV experienced more zonulopathy during cataract surgery (adjusted OR 2.2, 95% confidence interval: 1.3-3.7, p = 0.002). Combined phacoemulsification/PPV were significantly more likely to experience all 3 complications, and this effect was even greater for eyes with a prior PPV. Conclusions: All complications were rare; however, there was a significant association with prior PPV and intraoperative zonulopathy. Cataract surgeons must be aware of a patient's prior vitrectomy and plan accordingly for the increased risk of intraoperative complications.

show abstract

Section: Discussionsupporting

confidence: 91%

“…2020; Nagar et al. 2020). It is thought that inadvertent trauma to the lens capsule at the time injection may account for this association.…”

Section: Discussionmentioning

confidence: 99%

Prior pars plana vitrectomy and its association with adverse intraoperative events during cataract surgery

Mudie

Patnaik

Lynch

et al. 2021

Acta Ophthalmologica

View full text Add to dashboard Cite

show abstract

“…Accordingly, a total of 20 full-text articles were further assessed for eligibility, and 14 of them were excluded for different reasons. Ultimately, 6 articles that met the inclusion criteria were included in our meta-analysis [14,15,[24][25][26][27]. No additional studies were identified through a manual search of the reference lists of the included studies.…”

Section: Study Selectionmentioning

confidence: 99%

Intravitreal Injection Is Associated with Increased Posterior Capsule Rupture Risk during Cataract Surgery: A Meta-Analysis

Zhong

et al. 2021

Ophthalmic Res

View full text Add to dashboard Cite

Background: Although observational studies have suggested that prior intravitreal therapy may predict posterior capsule rupture (PCR) during cataract surgery, this finding is still controversial. Objective: To summarize current evidence on the association between prior intravitreal injection (IVI) and PCR during cataract surgery. Methods: A systematic literature search was performed up to October 27th, 2021. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using random-effects models. The potential association between IVI and PCR in future cataract surgeries was assessed using the following two models: “pooling the odds ratios of PCR in eyes with and without previous IVI(s)” and “pooling the odds ratios for PCR relative to each increase in the number of prior injections.” The quality of included studies was appraised using the Newcastle-Ottawa Scale. Results: 6 cohort studies were included in this meta-analysis, with a total of 1,051,097 eyes that underwent cataract surgery. Of these, 7,034 eyes were associated with previous IVI. The pooled odds of PCR in eyes with prior IVI was 2.01 (95% CI: 1.35–3.00) times higher than that of eyes without an IVI history. An increase in the number of previous IVI conferred increased odds of PCR of 1.03 (95% CI: 1.01–1.06). After excluding studies that failed to account for confounders, the significantly increased risk was not altered, and the significant heterogeneity was minimized in both models. Conclusion: This meta-analysis provides evidence that previous IVI significantly increases the risk of PCR during future cataract surgery. The risk of PCR should be discussed preoperatively with patients. Further studies are required to validate our findings and explore the underlying mechanisms.

show abstract

“…1103 Several studies reported a several-fold increase in capsular rupture and retained nuclear material in patients with a history of intravitreal injections. 782,1005,1104,1105 Careful preoperative and intraoperative evaluation of the capsule can sometimes detect capsular damage from intravitreal injections. The surgical approach with known damage to the capsule is similar to other conditions where there is a breach in the posterior capsule (e.g., posterior polar cataract).…”

Section: Cataract Surgery and Vitreoretinal Proceduresmentioning

confidence: 99%

“…[1106][1107][1108][1109][1110][1111] Management of such cataracts may be more complex, because capsular defects or weakened zonular fibers may be present. 782,1004,1105 The anterior chamber depth may also be unstable during surgery. Iris hooks can be helpful in these situations.…”

Section: Cataract Surgery After Pars Plana Vitrectomymentioning

confidence: 99%

Cataract in the Adult Eye Preferred Practice Pattern®

et al. 2022

View full text Add to dashboard Cite

show abstract

The Risk of Posterior Capsule Rupture during Phacoemulsification Cataract Surgery in Eyes with Previous Intravitreal Anti Vascular Endothelial Growth Factor Injections.

Cited by 8 publications

References 0 publications

Prior pars plana vitrectomy and its association with adverse intraoperative events during cataract surgery

Prior pars plana vitrectomy and its association with adverse intraoperative events during cataract surgery

Intravitreal Injection Is Associated with Increased Posterior Capsule Rupture Risk during Cataract Surgery: A Meta-Analysis

Cataract in the Adult Eye Preferred Practice Pattern®

Contact Info

Product

Resources

About