Exponential Increase in Anti-VEGF Treatments Linked to Higher Risk of Complications in Cataract Surgery, Study Finds

In the largest study of its kind, Canadian researchers from the University of Toronto have identified a higher risk of complications in cataract surgery patients with a history of anti-VEGF injections. These findings will be presented this week at AAO 2024, the 128th annual meeting of the American Academy of Ophthalmology.

The researchers analyzed data from the Ontario Health Insurance Plan (OHIP), Canada’s universal healthcare system, which provided a comprehensive pool of information. They focused on 163,663 patients treated for retinal conditions who underwent cataract surgery between 2009 and 2018. Of these, 3,243 patients had received anti-VEGF injections prior to their surgery.

By comparing those who received injections with patients who had no history of such treatments, the researchers found a significant increase in the risk of several post-operative complications.

Patients who had been treated with anti-VEGF medications showed a higher likelihood of experiencing the following complications after cataract surgery:

• Non-clearing vitreous hemorrhage (aHR 3.37, 95% CI 2.57–4.43)
• Retained lens fragments (aHR 2.00, 95% CI 1.02–3.91)
• Retinal detachment (aHR 3.63, 95% CI 2.47–5.35)
• Retinal tear (aHR 3.24, 95% CI 2.36–4.45)
• Intraocular lens (IOL) dislocation (aHR 1.97, 95% CI 1.31–2.97)
• Anterior vitrectomy (aHR 1.67, 95% CI 1.17–2.38)
• Glaucoma surgery (aHR 4.03, 95% CI 2.86–5.70)

The study did not find an increased risk of corneal transplants, IOL exchange, or IOL repositioning in patients with prior anti-VEGF treatments.

“The findings of this study highlight the importance of surgical planning to prevent and manage possible complications in patients who have had anti-VEGF injections,” lead researcher Winnie Yu, from the University of Toronto’s Temerty Faculty of Medicine, said in an AAO news release. “These patients should be thoroughly counseled about the potential risks before undergoing cataract surgery to ensure they can make an informed decision.”

As more people continue to receive anti-VEGF treatments, the findings of this research are critical in helping surgeons manage the complexities of cataract surgery for these patients, accorinding to the study authors.

The full details of the study will be unveiled at AAO 2024.