Patients who underwent previous intravitreal therapy have an increased risk of intraoperative complications during cataract surgery, new research suggests. An investigator from Lund University in Sweden created a risk model that he says can be used preoperatively to predict the risk of complications, such as posterior capsule rupture and zonular dehiscence.

The large-scale study included approximately 900,000 eyes that were part of the Swedish National Cataract Register between 2010 and 2018. Data was cross-referenced with the Swedish Macular Register that provided information on previous intravitreal therapy.

Overall, the rate of intraoperative complications was 0.86%. Patients were more likely to encounter complications if they had BCVA of 1logMAR or greater, were older than 90, male or diabetic or had pseudoexfoliation, glaucoma or previous intravitreal therapy. Other predictors included the surgeon’s experience (fewer than 600 surgeries), use of rhexis hooks, blue staining and mechanical pupil dilation.

The risk model can be used in a preoperative setting to predict the probability of intraoperative complications, facilitate planning of surgery and improve patient communications, the author suggested.

Af Segerstad PH. Risk model for intraoperative complication during cataract surgery based on data from 900,000 eyes: previous intravitreal injection is a risk factor. Br J Ophthalmol. April 22, 2021. [Epub ahead of print].