Intravitreal anti–VEGF injections tied to cataract development, surgery

Long-term treatment with intravitreal antivascular endothelial growth factor (anti-VEGF) appears to elevate the risk of developing cataract that requires surgical intervention, reports a study.

Overall, 603 patients with phakic lens status in both eyes at baseline who received 12 or more unilateral anti-VEGF injections were included in the analysis and followed-up for a median of 74 months.

At 10 years, the cumulative incidence of cataract surgery was 40.7 percent (95 percent confidence interval [CI], 35.9‒45.1) in the injected eye and 7.2 percent (95 percent CI, 4.1‒10.3) in the fellow eye. The injected eye (hazard ratio [HR], 8.174, 95 percent CI, 5.767‒11.586) and older age (HR, 1.069, 95 percent CI, 1.052‒1.086) significantly correlated with a higher risk of cataract surgery.

“At the time of surgery, all lens opacity grades, including nuclear, cortical, and posterior subcapsular, were significantly higher in injected eyes (p<0.001 for all), with the greatest difference observed in posterior subcapsular opacity,” the investigators said.

This retrospective, interventional case series study explored the relationship between intravitreal anti-VEGF injections and incident cataract surgery using electronic medical records. The investigators performed the Kaplan‒Meier survival analysis to assess cumulative incidence. They also analysed lens opacity grades at the time of surgery and change in best-corrected visual acuity before and after surgery.