Risk of Posterior Capsular Rupture during Phacoemulsification in Patients with the History of Anti-VEGF Intravitreal Injections: Results from the Pan-American Collaborative Retina Study (PACORES) Group.

Raul Velez-Montoya,J Fernando Arevalo,Rosa Dolz-Marco,Roberto Gallego-Pinazo,Arturo A Alezzandrini,Lihteh Wu,Mauricio Galvan-Chavez,María H Berrocal,Roberto Gonzalez-Salinas,Clara Martinez-Rubio,Idaira Sanchez-Santos,Marta S Figueroa,Marco Pellegrini

doi:10.1155/2021/5591865

Abstract

Purpose To assess the risk for capsular rupture during routine phacoemulsification in patients with a history of anti-VEGF injections and other possible risk modifiers such as treatment patterns, type of anti-VEGF agent, and experience of the surgeon, among others. Methods This study reviewed the medical records of 11,129 patients from 7 different hospitals in 5 countries. The study included 939 patients that underwent routine phacoemulsification and had a history of anti-VEGF therapy. We excluded patients with known risk factors for capsular rupture, as well as patients with a history of other retinal procedures. The study extracted data regarding general demographics, the number of previous injections, type of anti-VEGF agent, details of cataract surgery, and anti-VEGF treatment patterns. Results Overall prevalence of posterior capsular rupture: 7.45% (95% CI: 5.9–9.32%). The mean number of injections per patient was 3.37 ± 2.8. More than 50% of the patients received their last anti-VEGF injection within three months before cataract surgery. The complication rate during intravitreal injections was 1.07%. In the univariate analysis, the experience of the cataract surgeon (inexperience surgeons; OR: 2.93) and the history of prior anti-VEGF therapy (OR: 1.77) were significant risk indicators for PCR (p < 0.05). However, after controlling for age in the multivariate analysis, the trend did not reach a statistical significance. Conclusion The risk for capsular rupture is higher in patients with a history of intravitreal anti-VEGF injections.

Highlights

Raul Velez-Montoya,1 Idaira Sanchez-Santos,1 Mauricio Galvan-Chavez,1 Lihteh Wu,2 J
Introduction e identification of the vascular endothelial growth factor (VEGF) as the primary driver of choroidal neovascularization changed the treatment paradigm for all neovascular retinal diseases [1, 2]. is change led to the adoption and popularization of therapies based on intravitreal injections that may last for several years
We reviewed a total of 11,124 medical records from which 939 (114% of the desired sample) belonged to patients who underwent routine cataract extraction, had a history of intravitreal anti-VEGF agents, and fulfilled all inclusion and exclusion criteria

Summary

Introduction

Raul Velez-Montoya ,1 Idaira Sanchez-Santos, Mauricio Galvan-Chavez, Lihteh Wu ,2 J. To assess the risk for capsular rupture during routine phacoemulsification in patients with a history of anti-VEGF injections and other possible risk modifiers such as treatment patterns, type of anti-VEGF agent, and experience of the surgeon, among others. E study included 939 patients that underwent routine phacoemulsification and had a history of anti-VEGF therapy. We excluded patients with known risk factors for capsular rupture, as well as patients with a history of other retinal procedures. More than 50% of the patients received their last anti-VEGF injection within three months before cataract surgery. The experience of the cataract surgeon (inexperience surgeons; OR: 2.93) and the history of prior anti-VEGF therapy (OR: 1.77) were significant risk indicators for PCR (p < 0.05). E risk for capsular rupture is higher in patients with a history of intravitreal anti-VEGF injections. E most common are those related to the injection procedure, such as conjunctival hemorrhages. e more serious adverse events include vitreous hemorrhage, retinal detachment, and endophthalmitis [4,5,6]

Results

Discussion

Conclusion