June 2023
Volume 64, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2023
Incidence and associations of retinal detachment after Yttrium Aluminum Garnet (YAG) capsulotomy
Author Affiliations & Notes
  • Brian T Cheng
    Wills Eye Hospital, Philadelphia, Pennsylvania, United States
  • Bryce Hwang
    Wills Eye Hospital, Philadelphia, Pennsylvania, United States
  • Loh-Shan Bryan Leung
    Ophthalmology, Stanford University School of Medicine, Palo Alto, California, United States
  • Footnotes
    Commercial Relationships   Brian Cheng None; Bryce Hwang None; Loh-Shan Leung None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2023, Vol.64, 4549. doi:
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      Brian T Cheng, Bryce Hwang, Loh-Shan Bryan Leung; Incidence and associations of retinal detachment after Yttrium Aluminum Garnet (YAG) capsulotomy. Invest. Ophthalmol. Vis. Sci. 2023;64(8):4549.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Yttrium Aluminum Garnet (YAG) laser capsulotomy is the standard of care for the treatment of post-capsular opacification after cataract surgery. Previous studies suggest the incidence of retinal detachment (RD) after YAG capsulotomy ranges between 0.5-1.5%. This study aimed to determine the cumulative incidence of RD after YAG capsulotomy and identify associated risk factors.

Methods : Data were analyzed from adults ≥18 years enrolled in IBM® MarketScan®, a representative sample of US commercial insurance beneficiaries who underwent YAG capsulotomy between 2007-2016. Patients with previous RD were excluded. The primary study outcome was time to first RD after YAG capsulotomy, which was identified by CPT and ICD-9/ICD-10 codes. Multivariable Cox regression models were constructed to examine the association with socio-demographic characteristics, clinical comorbidities, and time from cataract surgery to YAG capsulotomy.

Results : Between 2007-2016, 414,174 adults underwent YAG capsulotomy in our cohort. RD was diagnosed in 718 (0.2%) patients within 3 months, 1221 (0.3%) within 6 months, and 1978 (0.5%) within one year after YAG capsulotomy (Figure 1). Patients with RD were more likely to be younger (62.2 vs 71.5 years), male (61.5% vs 38.1%), have diabetic retinopathy (13.2% vs 7.9%), lattice degeneration (3.6% vs 0.8%), posterior vitreous detachment (PVD) (16.7% vs 12.4%), and cataract surgery within 3 months of YAG capsulotomy (7.9% vs 4.0%) (P<.0001 for all).

In multivariable Cox regression models, time to RD was associated with male gender (adjusted hazard ratio [95% CI]: 2.50 [2.27-2.70]), lattice degeneration (2.68 [2.11-3.41]), diabetic retinopathy (1.44 [1.26-1.64]), PVD (1.53 [1.36-1.73]), and shorter interval between cataract surgery and YAG capsulotomy (≤3 months: 1.61 [1.36-1.93]), 3-12 months: 1.26 [1.13-1.41]), and inversely associated with age (≥65 years: 0.95 [0.94-0.95]) and comorbid diabetes (0.75 [0.66-0.85]) (P<.0001 for all).

Conclusions : One in 200 patients had RD within one year after YAG capsulotomy. Younger, male patients with a history of lattice degeneration, diabetic retinopathy, PVD, and recent cataract surgery had higher risk of RD. These findings may be used to guide informed consent discussions and identify patients at higher risk of RD who may benefit from close follow-up and monitoring.

This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.

 

Kaplan-Meier cumulative incidence of RD after YAG capsulotomy.

Kaplan-Meier cumulative incidence of RD after YAG capsulotomy.

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