Abstract
The present study estimated the 5-year cumulative probability of Nd:YAG laser posterior capsulotomy according to the diopter power of implanted hydrophobic acrylic intraocular lenses (IOLs). Data were retrospectively collected of 15,375 eyes having cataract surgery and in-the-bag implantation of hydrophobic acrylic monofocal IOLs at the Ophthalmology Unit of Kymenlaakso Central Hospital, Kotka, Finland between the years 2007 and 2016. The cumulative probability of Nd:YAG capsulotomy was calculated by Kaplan–Meier estimates, and potential risk factors were analyzed using the Cox proportional hazards model. The 5-year cumulative probability of Nd:YAG capsulotomy after cataract surgery was 27.4% (95% confidence interval (CI) 22.9–32.6%) for low-diopter (5–16.5 D) IOLs, 14.6% (13.8–15.5%) for mid-diopter (17–24.5 D) IOLs, and 13.6% (11.7–15.6%) for high-diopter (25–30 D) IOLs. A multivariate Cox regression analysis showed that low-diopter IOLs (HR 1.76; 95% CI 1.38–2.25; p < 0.001) were associated with an increased risk of Nd:YAG capsulotomy compared to mid-diopter IOLs over the follow-up period after accounting for other predictors. Real-world evidence shows that low-diopter IOLs are associated with significantly higher risk of Nd:YAG capsulotomy within five years following implantation. Estimation should help in evaluating the risks of cataract surgery in myopic eyes.
Highlights
Posterior capsular opacification (PCO) due to the proliferation and migration of lens epithelial cells (LECs) remains the most common long-term complication after cataract surgery, advancements in surgical technology appear to have decreased its incidence [1,2]
Patient age younger than 60 years (HR 1.41; 95% CI 1.14–1.73; p = 0.001) and female sex (HR 1.21; 95% CI 1.06–1.38; p = 0.006) were associated with an increased risk of Nd:YAG capsulotomy over the follow-up period, whereas implantation of SN60WF/AUT00T0 (HR 0.63; 95% CI 0.56–0.72; p < 0.001) or ZA9003 (HR 0.53; 95% CI 0.44–0.65; p < 0.001) in comparison with ZCB00/PCB00 intraocular lenses (IOLs) was associated with a decreased risk
The current study showed that the need for Nd:YAG capsulotomy to treat PCO was approximately two times higher for patients implanted with low-diopter IOLs compared to higher diopter IOLs
Summary
Posterior capsular opacification (PCO) due to the proliferation and migration of lens epithelial cells (LECs) remains the most common long-term complication after cataract surgery, advancements in surgical technology appear to have decreased its incidence [1,2]. The risk factors of PCO have been studied extensively, but the effect of myopia on the incidence of PCO is still not precisely known. Several studies have evaluated the effects of intraocular lens (IOL) design and materials on prevention of PCO and subsequent Nd:YAG capsulotomy. Results suggest that a sharp optic edge of the IOL and a firm capsule–IOL adhesion could inhibit LEC migration and PCO [3,4,5]. A previous prospective study investigating the capsule–IOL interaction in emmetropic and highly myopic eyes revealed weak capsular adhesion and incompletely adhesive types of capsular bend formation in highly myopic eyes, which appeared to increase the likelihood of PCO during the early 28-day postoperative period [6]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
