Effect of Prior Anti-VEGF Injections on the Risk of Retained Lens Fragments and Endophthalmitis after Cataract Surgery in the Elderly.
dc.contributor.author | Hahn, Paul | |
dc.contributor.author | Yashkin, Arseniy P | |
dc.contributor.author | Sloan, Frank A | |
dc.coverage.spatial | United States | |
dc.date.accessioned | 2017-06-05T17:52:59Z | |
dc.date.available | 2017-06-05T17:52:59Z | |
dc.date.issued | 2016-02 | |
dc.description.abstract | PURPOSE: To investigate the effect of prior intravitreal anti-vascular endothelial growth factor (VEGF) injections on surgical and postoperative complication rates associated with cataract surgery in a nationally representative longitudinal sample of elderly persons. DESIGN: Retrospective, longitudinal cohort analysis. PARTICIPANTS: A total of 203 643 Medicare beneficiaries who underwent cataract surgery from January 1, 2009, to December 31, 2013. METHODS: By using the 5% sample of Medicare claims data, the study assessed risks of 3 adverse outcomes after receipt of cataract surgery for beneficiaries with a history of intravitreal injections. Risks of these outcomes in beneficiaries with a history of intravitreal injections relative to those without were calculated using the Cox proportional hazard model. MAIN OUTCOME MEASURES: The primary outcome was the risk of subsequent removal of retained lens fragments (RLFs) within 28 days after cataract surgery. Secondary outcomes were a new diagnosis of acute (<40 days) or delayed-onset (40+ days) endophthalmitis and risk of a new primary open-angle glaucoma (POAG) diagnosis within 365 days after cataract surgery. RESULTS: Prior intravitreal anti-VEGF injections were associated with a significantly increased risk of subsequent RLF removal within 28 days after cataract surgery (hazard ratio [HR], 2.26; 95% confidence interval [CI], 1.19-4.30). Prior injections were also associated with increased risk of both acute (HR, 2.29; 95% CI, 1.001-5.22) and delayed-onset endophthalmitis (HR, 3.65; 95% CI, 1.65-8.05). Prior injections were not a significant indicator of increased risk of a new POAG diagnosis. CONCLUSIONS: A history of intravitreal injections may be a risk factor for cataract surgery-related intraoperative complications and endophthalmitis. Given the frequency of intravitreal injections and cataract surgery, increased preoperative assessment, additional intraoperative caution, and postoperative vigilance are recommended in patients with a history of intravitreal injections undergoing cataract extraction. | |
dc.identifier | ||
dc.identifier | S0161-6420(15)00652-1 | |
dc.identifier.eissn | 1549-4713 | |
dc.identifier.uri | ||
dc.language | eng | |
dc.publisher | Elsevier BV | |
dc.relation.ispartof | Ophthalmology | |
dc.relation.isversionof | 10.1016/j.ophtha.2015.06.040 | |
dc.subject | Aged | |
dc.subject | Aged, 80 and over | |
dc.subject | Angiogenesis Inhibitors | |
dc.subject | Cataract Extraction | |
dc.subject | Endophthalmitis | |
dc.subject | Female | |
dc.subject | Follow-Up Studies | |
dc.subject | Glaucoma, Open-Angle | |
dc.subject | Humans | |
dc.subject | Incidence | |
dc.subject | Intraoperative Complications | |
dc.subject | Intravitreal Injections | |
dc.subject | Lens Subluxation | |
dc.subject | Male | |
dc.subject | Medicare | |
dc.subject | Retrospective Studies | |
dc.subject | Risk Factors | |
dc.subject | United States | |
dc.subject | Vascular Endothelial Growth Factor A | |
dc.title | Effect of Prior Anti-VEGF Injections on the Risk of Retained Lens Fragments and Endophthalmitis after Cataract Surgery in the Elderly. | |
dc.type | Journal article | |
duke.contributor.orcid | Yashkin, Arseniy P|0000-0002-1185-148X | |
pubs.author-url | ||
pubs.begin-page | 309 | |
pubs.end-page | 315 | |
pubs.issue | 2 | |
pubs.organisational-group | Center for Child and Family Policy | |
pubs.organisational-group | Center for Population Health & Aging | |
pubs.organisational-group | Duke | |
pubs.organisational-group | Duke Population Research Center | |
pubs.organisational-group | Duke Population Research Institute | |
pubs.organisational-group | Economics | |
pubs.organisational-group | Faculty | |
pubs.organisational-group | Nursing | |
pubs.organisational-group | Sanford | |
pubs.organisational-group | Sanford School of Public Policy | |
pubs.organisational-group | School of Nursing | |
pubs.organisational-group | Staff | |
pubs.organisational-group | Trinity College of Arts & Sciences | |
pubs.publication-status | Published | |
pubs.volume | 123 |
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