Effect of prior intravitreal injections on the risk of posterior capsule rupture during cataract surgery: a single-surgeon matched case-control study

To evaluate the impact of a history of intravitreal injections (IVI) for various retinal diseases on the risk of posterior capsule rupture (PCR) during cataract surgery in a single-surgeon setting. This retrospective, matched case-control study included 93 eyes of 74 patients who underwent phacoemulsification after prior IVI (anti-VEGF and/or dexamethasone) and 93 control eyes without prior IVI, matched for age, gender, laterality and axial length. All surgeries were performed by the same experienced surgeon. The primary outcome was the incidence of PCR. Statistical analyses was performed using Chi-square tests and logistic regression. All eyes in the IVI group had received at least two injections (mean: 5.71 ± 3.5). PCR occurred in 3 eyes (3.2%) in both the IVI and control groups (p = 1.00). There was no statistically significant difference in overall intraoperative complication rates between the two groups (8.6% vs. 7.5%, p = 0.79). Logistic regression analysis revealed no significant association between PCR and the number of injections, injection agent (anti-VEGF or dexamethasone), time from first injection to surgery, or retinal disease subtype (p > 0.05 for all). In this study, a history of IVI was not associated with an increased risk of PCR or other intraoperative complications during cataract surgery. These findings suggest that cataract surgery following IVI can be safely performed by an experienced surgeon without an increased risk of PCR.