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Victoria Jean Miller, Jennifer L Patnaik, Anne M Lynch, Michael Taravella, Alan G Palestine, Ram H Nagaraj; Risk Factors Predisposing to Early Nd:YAG Capsulotomy in a Colorado Cohort. Invest. Ophthalmol. Vis. Sci. 2018;59(9):4797. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
Posterior capsular opacification (PCO) develops as a common complication of cataract surgery when residual lens epithelial cells proliferate and coat the intraocular lens implant. Early Nd:YAG laser capsulotomy is the main effective treatment, but complications of this treatment include retinal detachment, damage to the intraocular lens implant, cystoid macular edema, increase in intraocular pressure, and others. The purpose of this study was to determine the risk factors predisposing to early Nd:YAG laser capsulotomy in a Colorado cohort of patients who received cataract surgery between January 2015 and July 2016.
A retrospective cohort study was conducted of 3,088 records from the University of Colorado Cataract Surgery Outcomes Registry. Patients under 55 years of age (n=259) and traumatic cataracts (n=2) were excluded from the analytic data set. The main outcome of the study was early Nd:YAG laser as treatment for PCO. Risk factors examined included: gender, race/ethnicity, age, aspirin use, autoimmune disease, uveitis, cardiovascular disease, glaucoma, combined and complicated surgery, and type of lens. Risk factors significantly associated (P<0.05) with early Nd:YAG in univariate analysis were include in a multivariable logistic regression model. P values were obtained from logistic regression with general estimating equations to account for inter-eye correlation.
In this cohort, 96 of 2827 (3.4%) patients required an early Nd:YAG. Average follow up timewas 244.8 days. The study population was 57.7% female and the average age was 71.5 (SD 8.2). Patient race/ethnicity were 74.0% White, 8.8% African-American, 7.6% Hispanic, 4.4% Asian and 5.1% other or unknown race/ethnicity. Most patients, 91.5%, had a monofocal lens implanted, 6.5% had a toric lens, and 2.0% had a multi-focal lens. The only factors significantly associated with early Nd:YAG in the multivariable logistic model were gender (adjusted odds ratio [AOR]: 1.73, 95% confidence interval [CI]: 1.06-2.81), Hispanic ethnicity (AOR: 0.20, CI: 0.05-0.83), multifocal lens (AOR: 2.94, CI: 1.23-7.03), and age (AOR: 0.95, CI: 0.92-0.98).
Female patients and patients who received a multi-focal lens were at a significantly elevated risk of PCO requiring early Nd:YAG, whereas, Hispanic patients were significantly less likely to require early Nd:YAG. Interestingly, older patients are at a lower risk of requiring early Nd:YAG.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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