Patients with retinal vein occlusion (RVO) can benefit from cataract surgery, a U.K.-based study has found.1
Study rationale. “There is insufficient evidence to inform patients with RVO on their prognosis after cataract surgery,” said lead author Ahmed B. Sallam, MD, PhD, FRCOphth, at the Jones Eye Institute in Little Rock, Arkansas. “Very few studies have evaluated the visual outcomes of cataract surgery in these patients.” In addition, he said, “there is a lack of studies documenting rates of intraoperative complications such as posterior capsular rupture (PCR) or zonular dialysis” in patients with RVO.
Study specifics. For this retrospective study, researchers pooled data from eight ophthalmology departments affiliated with the U.K. National Health Service, covering a 15-year period from July 2000 to May 2015. All told, 71,449 eyes met inclusion criteria; of these, 563 were in the RVO group, and 70,886 were in the reference group.
Outcomes and complications. Before cataract surgery, eyes with RVO had a visual acuity (VA) of 20/100, compared to 20/70 for those in the reference group. This improved postoperatively to 20/50 for RVO and 20/25 for reference eyes. In addition, at four to 12 weeks postoperatively, 55.1% of eyes with RVO had gained 3 or more Snellen lines in vision, versus 64.55% of reference eyes.
This analysis found no difference in the rate of PCR or dropped lens fragments between the two groups. However, Dr. Sallam said, the RVO group had significantly higher rates of zonular dialysis than did reference eyes (1.06% vs. 0.64%; p = 0.0269). With regard to postoperative cystoid macular edema, the RVO group had a higher rate than did reference eyes (3.02% vs. .87%, respectively; p = .021).
Looking ahead. The researchers believe that their data “will help surgeons more accurately counsel patients on the expected visual outcome and the risks of intraoperative complications in the setting of cataract surgery with RVO,” Dr. Sallam said.
He noted that, while the study is limited by its retrospective design, “We provided a large sample size on RVO eyes undergoing cataract surgery from several centers using the same electronic medical records platform, which increases the generalizability of our results.” In addition, he noted that, while a prospective randomized controlled study represents the gold standard level of evidence, conducting such a study for cataract surgery in eyes with RVO “is difficult and is unlikely to be feasible.”
1 Ponder CM et al. J Cataract Refract Surg. Published online Sept. 27, 2021.
Relevant financial disclosures: Dr. Sallam—None.
For full disclosures and the disclosure key, see below.
Full Financial Disclosures
Dr. Ambati Allergan: C; Biogen: C; Boehringer-Ingelheim: C; DiceRx: O; iVeena Delivery Systems: O; iVeena Holdings: O; Inflammasome Therapeutics: O; Immunovant: C; Janssen: C; Olix Pharmaceuticals: C; Retinal Solutions: C; Saksin LifeSciences: C; University of Kentucky: P; University of Virginia: P.
Dr. Field None.
Dr. Pearson None.
Dr. Sallam None.
||Consultant fee, paid advisory boards, or fees for attending a meeting.
||Employed by a commercial company.
||Lecture fees or honoraria, travel fees or reimbursements when speaking at the invitation of a commercial company.
||Equity ownership/stock options in publicly or privately traded firms, excluding mutual funds.
||Patents and/or royalties for intellectual property.
||Grant support or other financial support to the investigator from all sources, including research support from government agencies (e.g., NIH), foundations, device manufacturers, and/or pharmaceutical companies.
More from this month’s News in Review