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Previous Intravitreal Therapy Is Associated with Increased Risk of Posterior Capsule Rupture during Cataract Surgery.

Abstract：

PURPOSE:To investigate if previous intravitreal therapy is a predictor of posterior capsule rupture (PCR) during cataract surgery. DESIGN:Multicenter, national electronic medical record (EMR) database study with univariate and multivariate regression modeling. PARTICIPANTS:A total of 65 836 eyes of 44 635 patients undergoing cataract surgery. METHODS:Anonymized data were extracted for eyes undergoing cataract surgery from 20 hospitals using the same EMR for cases performed between 2004 and 2014. Variables included as possible risk indicators for PCR were age, sex, number of previous intravitreal injections, indication for intravitreal therapy, grade of healthcare professional administering intravitreal therapy, advanced cataract, and cataract surgeon grade. MAIN OUTCOME MEASURES:Presence or absence of posterior capsular rupture during cataract surgery. RESULTS:Data were available on 65 836 cataract operations, of which 1935 had undergone previous intravitreal therapy (2.9%). In univariate regression analyses, patient age, advanced cataract, junior cataract surgeon grade, and number of previous intravitreal injections were significant predictors of PCR. By considering the number of previous intravitreal injections as a continuous variable, the odds ratio for PCR per intravitreal injection was 1.04 (P = 0.016) after adjusting for age, advanced cataract, and cataract surgeon grade. Repeat analysis considering intravitreal injections as a categoric variable showed 10 or more previous injections were associated with a 2.59 times higher likelihood of PCR (P = 0.003) after again adjusting for other significant independent predictors. CONCLUSIONS:Previous intravitreal therapy is associated with a higher likelihood of PCR during cataract surgery. This study provides data to help inform surgeons and patients about the risk of complications when undergoing cataract surgery after multiple prior intravitreal injections. Further investigation is required to determine the cause behind the increased PCR risk.

journal_name

Ophthalmology

journal_title

Ophthalmology

authors

Lee AY,Day AC,Egan C,Bailey C,Johnston RL,Tsaloumas MD,Denniston AK,Tufail A,United Kingdom Age-related Macular Degeneration and Diabetic Retinopathy Electronic Medical Records Users Group.

doi

10.1016/j.ophtha.2016.02.014

subject

Has Abstract

pub_date

2016-06-01 00:00:00

pages

1252-6

issue

6

eissn

0161-6420

issn

1549-4713

pii

S0161-6420(16)00178-0

journal_volume

123

pub_type

杂志文章,多中心研究

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