Previous Intravitreal Therapy Is Associated with Increased Risk of Posterior Capsule Rupture during Cataract Surgery
| Autor: | Salim Natha, Sajjad Mahmood, Geeta Menon, Louise Downey, Alastair K Denniston, Aires Lobo, Elizabeth Wilkinson, Martin McKibbin, Atul Varma, Alan Fitt, Toks Akerele, Saher Al-Husainy, Catherine A Egan, Adnan Tufail, Kaveri Mandal, Usha Chakravarthy, Marie D Tsaloumas, Clare Bailey, Christopher Brand, Vineeth Kumar, Alexander C Day, Rehna Khan, Aaron Y. Lee, Robert L. Johnston, Jong Min Ong |
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| Rok vydání: | 2016 |
| Předmět: |
Male
Vascular Endothelial Growth Factor A medicine.medical_specialty Multivariate analysis Visual acuity genetic structures medicine.medical_treatment Lens Capsule Crystalline Visual Acuity Angiogenesis Inhibitors 03 medical and health sciences 0302 clinical medicine Retinal Diseases Risk Factors Ophthalmology medicine Electronic Health Records Humans 030212 general & internal medicine Glucocorticoids Aged Aged 80 and over Phacoemulsification business.industry Diabetic retinopathy Odds ratio Middle Aged Cataract surgery medicine.disease Posterior Capsular Rupture Ocular eye diseases Confidence interval Surgery Vitreous Body Posterior capsule Intravitreal Injections Multivariate Analysis 030221 ophthalmology & optometry Female sense organs medicine.symptom business |
| Zdroj: | Ophthalmology. 123:1252-1256 |
| ISSN: | 0161-6420 |
| DOI: | 10.1016/j.ophtha.2016.02.014 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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