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Perform cataract surgery midway between anti-VEGF injections

Healio Optometry1d ago1 min read

KIAWAH ISLAND, S.C. — Cataract surgery should be performed midway between any anti-VEGF injections a patient may be receiving, Steve Charles, MD, said at Kiawah Eye and Retina.“I’ve heard people say ... ‘Just for your convenience, we'll do the injection while you're in the OR, having cataract surgery,’” Charles said during his presentation.{{VIDEO}}“It is absolutely incorrect to inject the day before or during cataract surgery or the day after,” he told Healio.If a patient develops a condition such as toxic anterior segment syndrome or vasculitis postoperatively, there is no way to know if it

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AI Summary

Quick Take

Dr. Steve Charles advises that cataract surgery should be scheduled exactly midway between a patient's anti-VEGF injections rather than concurrently. This recommendation specifically rejects the practice of performing injections in the operating room during cataract surgery, which is sometimes done for patient convenience.

Why It Matters

While combining procedures might seem efficient, it creates a significant diagnostic dilemma if postoperative complications arise. If a patient presents with severe inflammation or a reaction like toxic anterior segment syndrome (TASS) or vasculitis, the clinician cannot distinguish whether the cataract surgery or the anti-VEGF agent was the trigger. Maintaining a clear temporal buffer between the two ensures that any adverse events can be accurately attributed and managed.

Key Details

Cataract surgery should be timed to fall at the midpoint of the anti-VEGF injection cycle.
Injecting the day before, during, or the day after cataract surgery is considered clinically incorrect by Dr. Charles.
The primary concern is the inability to differentiate the cause of postoperative complications like toxic anterior segment syndrome (TASS) or vasculitis.
Practitioners are cautioned against 'convenience' injections performed in the OR during the cataract procedure.

Practice Implications

Surgeons and co-managing optometrists should coordinate closely with retina specialists to ensure cataract procedures are scheduled during the 'quiet' window between injections. Clinicians should resist the temptation to perform injections in the OR to ensure that any adverse inflammatory events can be accurately diagnosed and treated without ambiguity.

Who's Affected

Cataract SurgeonsRetina SpecialistsComprehensive OphthalmologistsSurgical Coordinators

Evidence StrengthModerate

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