PCR Risk Rises Following Anti-VEGF Treatment

Journal Highlights

Journal of Cataract & Refractive Surgery
Published online Sept. 10, 2019

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In a retrospective review, Nagar et al. looked at the relationship between pri­or intravitreal anti-VEGF therapy and the risk of posterior capsular rupture (PCR) during phacoemulsification. They found that PCR occurred in more than 9% of eyes with previous anti-VEGF injections, compared with less than 2% of eyes that did not have this treatment. A higher number of injec­tions denoted a greater risk of rupture.

For this study, the authors reviewed electronic health records of patients who underwent phacoemulsification at a single eye care center in London during a two-year period. Collected data included patient demographics, indication for intravitreal therapy, number of intravitreal injections, and surgical complications. The primary outcome measure was PCR during phacoemulsification, as defined by the Royal College of Ophthalmologists’ database audit of cataract surgery. Univariate logistic regression was used to explore associations between intra­vitreal anti-VEGF treatment and the occurrence of PCR.

Data were available for 4,047 eyes; of these, 108 had received injections of an anti-VEGF agent. Three eyes had trauma to the posterior capsule preoperatively and were excluded from final analyses. Logistic regression (after excluding those eyes) confirmed that prior anti-VEGF treatment carries a greater risk of PCR (9.26% vs. 1.88% for eyes that had not received intravit­real injections; p < .0001). A dose-dependent relationship was found for the number of anti-VEGF injec­tions and the likelihood of PCR: 8.6% relative risk per injection. Eyes that received more than 10 injections had a higher PCR rate than those with fewer injections (6.1% vs. 14.3%, p = .18).

The authors recommend expand­ing their study to further explore and understand this relationship.

The original article can be found here.