Factors Associated with the Development and Progression of Posterior Capsule Opacification Requiring YAG Capsulotomy after Cataract Surgery.

Abstract

Purpose : To investigate risk factors associated with the development and elapsed time to clinically significant posterior capsule opacification (PCO) in pseudophakic patients requiring YAG capsulotomy.

Methods : In this case-control study, we included 300 patients (>18 years) with clinically significant PCO that underwent YAG capsulotomy (YAG:Cap) up to 3 years after uncomplicated cataract surgery (YAG:Cap group). All cataract surgeries were performed between 2011-2014. We randomly selected 300 patients that underwent uncomplicated cataract surgery between 2011-2014 without development of clinically significant PCO requiring YAG:Cap up to 3 years (control group). In patients with both eyes that underwent cataract surgery and YAG:Cap, only the eye that underwent surgery earlier was included in the study. The indications for YAG:Cap were either significant decline in visual acuity or PCO that hindered examination of the posterior segment. Exclusion criteria included eyes with traumatic cataracts, complicated cataract surgery, surgeries not performed at the Kresge Eye Institute, surgical techniques used other than phacoemulsification, and eyes that underwent cataract surgery with an additional procedure.

Results : In comparison to the control group, the YAG:Cap group included patients with a younger age (p<0.001), more males (p=0.04), fewer African American patients (p<0.001), fewer patients with hypertension (p<0.01), and more patients with the Bausch & Lomb MI60 intraocular lens (IOL) (p<0.001). The logistic regression analysis demonstrated a significant association between requiring YAG:Cap and younger age (<0.001), Caucasian race (p<0.01), presence of glaucoma (p<0.01), and using IOLs other than the Alcon SA60AT (p<0.05 for other IOLs). The elapsed time to requiring YAG:Cap was significantly sooner in Caucasian patients (p = 0.04), patients with uveitis (p=0.02), and patients with insertion of IOLs other than SA60AT (p<0.001).

Conclusions : Younger age and presence of glaucoma were significantly associated with development of PCO requiring YAG:Cap within 3 years of uncomplicated cataract surgery. Non-African American race and IOLs other than SA60AT had significant association with and shorter elapsed time to development of PCO requiring YAG:Cap. Patients with a history of uveitis had a shorter elapsed time to development of PCO requiring YAG:Cap.

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.