Risk factors associated with higher incidence of Nd:YAG capsulotomy post-cataract surgery: UK EMR database study

Session Details

Session Title: Posterior Capsule Opacification/IOL Power Calculations

Session Date/Time: Tuesday 17/09/2019 | 14:00-16:00

Paper Time: 14:00

Venue: Free Paper Forum: Podium 2

First Author: : P.Ursell UK

Co Author(s): :    M. Dhariwal   D. O'Boyle   J. Khan   A. Venerus   A. Muthutantri                 

Abstract Details

Purpose:

Nd: YAG laser capsulotomy is the only effective surgical treatment for posterior capsule opacification (PCO) and a proxy measure for visually significant PCO. A large retrospective analysis of UK NHS cataract records was performed to assess the factors associated with higher risk of Nd:YAG laser capsulotomy incidence post-cataract surgery.

Setting:

UK NHS Ophthalmology Clinics.

Methods:

Electronic medical record data of patients aged ≥65 years from 7 sites who underwent cataract surgery between 2010-2013 with in-the-bag placement of monofocal, acrylic intraocular lenses (IOLs) and followed up for at least 3 years were analysed. Multivariate logistic regression was used to model the risk of Nd:YAG adjusting for patient demographics, clinical and IOL characteristics, and surgery-related factors.

Results:

52,162 eyes from 39,324 patients were analysed. Factors found to be significantly associated (p<0.05) with a higher risk of Nd:YAG post-cataract surgery included implantation of hydrophilic IOLs (OR 4.1), presence of post-operative complications (OR 2.0), year of cataract surgery (OR 1.3 for 2011 vs 2010; OR 1.4 for 2012 vs 2010), larger pupil size (OR 1.3), female sex (OR 1.2), presence of any co-pathologies (OR 1.2), including diabetic retinopathy (OR 1.3), high myopia (OR 1.3), and glaucoma (OR 1.2). IOL edge characteristics (360 vs. non-360) were not found to be associated with increased risk of Nd:YAG (p=0.74).

Conclusions:

This study identified factors associated with increased risk of Nd:YAG capsulotomy incidence. The findings suggest that implantation of hydrophilic acrylic IOLs and presence of post-operative complications appear to have the largest impact on Nd:YAG incidence.

Financial Disclosure:

is employed by a for profit company with an interest in the subject of the presentation, research is funded, fully or partially, by a competing company, receives consulting fees, retainer, or contract payments from a competing company