Nagar Anindyt M, Luis Joshua, Kainth Nimrath, Panos Georgios D, Mckechnie Cordelia J, Patra Sudeshna
Eye Treatment Centre, Whipps Cross University Hospital, Barts Health NHS Trust, London, UK.
University College London, London, UK.
J Cataract Refract Surg. 2020 Jan 21. doi: 10.1097/j.jcrs.0000000000000047.
To investigate if previous intravitreal anti vascular endothelial growth factor (VEGF) injections are a predictor for posterior capsule rupture (PCR) during phacoemulsification cataract surgery.
National Health Service: Whipps Cross University Hospital Eye Treatment Centre. District General, London, United Kingdom DESIGN:: Single centre, retrospective, electronic medical record (EMR) database study with univariate analysis.
EMR (Medisoft) was used to extract data for eyes undergoing phacoemulsification surgery between 01.08.16 to 01.01.18. Patient demographics, indication for intravitreal therapy, treatment type, number of previous intravitreal injections (IVI), diabetic status, surgeon grade and operative complications were included as variables for analysis.
Data was available for 4047 cataract operations. Of these, 108 had undergone previous anti-VEGF IVI treatment. Three eyes were noted to have pre-operative PC trauma and were excluded from the final analysis. The logistic regression analysis after exclusion of the eyes with pre-existing damage to the PC confirmed that prior anti-VEGF IVI treatment was associated with an increased risk of PCR when compared to the non IVI group (9.26% vs 1.88%, p<0.0001). There is a dose dependent relationship between the number of anti-VEGF injections and the likelihood of PCR.
Previous intravitreal anti-VEGF injections are significantly correlated with an increased risk of surgical PCR despite the absence of visible structural damage to the PC pre-operatively.
研究既往玻璃体内注射抗血管内皮生长因子（VEGF）是否为白内障超声乳化手术中后囊破裂（PCR）的预测因素。
英国国家医疗服务体系：惠普斯十字大学医院眼科治疗中心。伦敦地区综合医院 设计：单中心、回顾性电子病历（EMR）数据库研究及单因素分析。
使用EMR（Medisoft）提取2016年8月1日至2018年1月1日期间接受超声乳化手术的眼睛的数据。患者人口统计学资料、玻璃体内治疗指征、治疗类型、既往玻璃体内注射（IVI）次数、糖尿病状态、手术医生级别和手术并发症作为分析变量。
有4047例白内障手术的数据可用。其中，108例曾接受过抗VEGF玻璃体内注射治疗。3只眼术前存在后囊膜创伤，被排除在最终分析之外。排除术前已有后囊膜损伤的眼睛后进行的逻辑回归分析证实，与未接受玻璃体内注射组相比，既往抗VEGF玻璃体内注射治疗与后囊破裂风险增加相关（9.26%对1.88%，p<0.0001）。抗VEGF注射次数与后囊破裂可能性之间存在剂量依赖关系。
尽管术前后囊膜无可见结构损伤，但既往玻璃体内注射抗VEGF与手术中后囊破裂风险增加显著相关。
