Prior intravitreal injection tied to complications following cataract surgery

Complications following cataract surgery appear to be more frequent among patients with prior intravitreal injection (IVI) therapy than among those without, as shown in a retrospective study.

Researchers used data from the TriNetX aggregated research network. They identified 16,356 patients with IVI therapy within 20 years of cataract surgery and 512,152 who did not receive prior IVI (control). Those who had lensectomy or pars plana vitrectomy before cataract surgery were excluded.

Propensity score matching (PSM) was applied to balance for demographics, systemic, and ocular comorbidities. The resulting cohort included 14,240 patients in the IVI group and 14,240 patients in the control group.

Outcomes included rate of retinal detachment, retinal detachment repair, anterior vitrectomy, retained lens, dislocated intraocular lens (IOL), secondary lens procedure, and endophthalmitis within 14, 30, and 90 days of cataract surgery.

The number of aggregate of complications within 90 days of cataract surgery was higher in the IVI group than in the control group (3.3 percent vs 2.4 percent; relative risk [RR], 1.34, 95 percent confidence interval [CI], 1.16–1.54).

Retinal detachment repair occurred more frequently in the IVI vs control group both at 30 days (RR, 1.84, 95 percent CI, 1.27–2.66) and 90 days (RR, 2.05, 95 percent CI, 1.65–2.54). Among patients with diabetic retinopathy, IVI was associated with an increased incidence of anterior vitrectomy at 90 days (RR, 1.24, 95 percent CI, 0.85–1.79).

Overall, patients with diabetic retinopathy and prior IVI exposure had more lensectomies, retinal detachment repairs, and secondary procedures.

The findings suggest that IVI treatment history should be considered in preoperative planning.