Intraoperative Complications and Visual Outcomes of Cataract Surgery in Patients with Retinal Vein Occlusion: A Multicenter Database Study

PURPOSE To compare the visual outcome and the rate of intraoperative complications in eyes with and without retinal vein occlusion (RVO) underwenting phacoemulsification over a period of 15 years in a real-world clinical setting. SETTING Eight independent United Kingdom National Health Service ophthalmology departments. DESIGN Retrospective, multicenter cohort study. METHODS Eyes were classified based on the presence or absence of RVO. For the visual acuity (VA) analysis and the incidence of postoperative cystoid macular edema (CME), eyes with any co-pathology, combined ocular surgical procedures, intraoperative complications, or diabetes were excluded. RESULTS Of 178,856 eyes, 1,796 eyes with RVO preoperatively and 177,060 eyes without RVO were allocated to the RVO group and reference group, respectively. Cataract surgery in eyes with RVO was associated with an improvement in mean VA of 0.35 LogMAR (3-4 Snellen lines) and a substantial gain (≥ 0.30 LogMAR units [3-Snellen lines]) in 55.10 % at the 4-12 weeks postoperatively. Mean postoperative VA was worse in eyes with RVO compared to eyes without RVO at 4-12 weeks (logMAR 0.40 vs. 0.12 [20/50 vs. 20/25]; p <0.0001). The proportions of eyes achieving a visual gain of ≥ 0.3 logMAR (3 Snellen lines) was also lower in eyes with RVO (55.10% vs. 64.55%; p = 0.0076). There was no difference in posterior capsule rupture rates between the 2 groups (1.73% vs. 1.72%; p = 0.9741). CONCLUSIONS We found a significant improvement in postoperative vision in eyes with RVO after cataract surgery though this improvement was worse than eyes without RVO.