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The following is a summary of “Risk of Cataract Surgery Complications in Patients with Prior Intravitreal Injection Therapy,” published in the January 2025 issue of Ophthalmology by Zhao et al. 

Researchers conducted a retrospective study to compare cataract surgery complication rates in individuals with and without prior intravitreal injection (IVI) pharmacotherapy.  

They used the TriNetX (Cambridge, MA) electronic health records research network to compare patients with a history of IVI therapy within 20 years of cataract surgery to a control group. Propensity score matching (PSM) was used to balance baseline demographics and systemic and ocular co-morbidities. Individuals with a history of lensectomy or pars plana vitrectomy (PPV) before cataract surgery were excluded.  

The results showed that prior to PSM, 16,356 patients with IVI therapy and 5,12,152 without IVI therapy underwent cataract surgery. After PSM, both groups consisted of 14,240 patients. The IVI group had a higher rate of aggregate complications within 90 days of cataract surgery (3.3%) compared to controls (2.4%) (RR 1.34; 95% CI, 1.16-1.54; P <0.0005). The IVI group also had a higher risk of retinal detachment (RD) repair at 30 days (RR 1.84; 95% CI, 1.27-2.66; P =0.001) and 90 days (RR 2.05; 95% CI, 1.65-2.54; P <0.0005). No significant associations were found between IVI and other complications, except in patients with diabetic retinopathy (DR). In patients with DR, IVI was linked to higher rates of lensectomy, RD repair, and secondary procedures (P <0.0005 for all) at 90 days.  

Investigators concluded that patients with prior IVI experienced more complications after cataract surgery, primarily related to RD, and IVI treatment history should have been considered in pre-operative planning. 

 Source: ajo.com/article/S0002-9394(25)00023-6/abstract