Journal List > J Korean Ophthalmol Soc > v.54(9) > 1009470

Yoo, Yang, Lee, and Kim: Incidence and Risk Factors of Nd:YAG Capsulotomy in Adult Cataract Patients Younger than 50 Years of Age

Abstract

Purpose

To evaluate the cumulative incidence and estimate the risk factors of Nd:YAG capsulotomy due to posterior cap-sular opacification in adult cataract patients younger than 50 years of age.

Methods

In the present study we retrospectively reviewed 118 consecutive eyes that received phacoemulsification and in-traocular lens implantation. We analyzed the cumulative incidence of Nd:YAG posterior capsulotomy and the associated risk factors.

Results

The cumulative incidence of posterior capsulotomy was 4.24%, 5.08%, 8.47%, 15.25%, and 20.34% in adults younger than 50 years of age at 3 months, 6 months, 12 months, 24 months, and more than 24 months after cataract sur-gery, respectively. The nuclear type (p = 0.021) and the mature type (p = 0.014) cataract groups were strongly associated with an increased risk of posterior capsulotomy compared with the posterior subcapsular type. The hydrophobic and single-piece intraocular lens caused the lowest incidence of posterior capsulotomy among intraocular lenses used for cata-ract surgery (p = 0.028). The subgroup analysis showed no statistical significance between gender, existence of diabetic mellitus or glaucoma, intraocular lens haptic material and the risk of posterior capsulotomy (p > 0.05).

Conclusions

The cumulative incidence of Nd:YAG capsulotomy was 20.34% in adults younger than 50 years of age and at more than 24 months after cataract surgery. The risk factors associated with posterior capsulotomy included nuclear and mature cataract types. Additionally, there was a difference in the incidence of posterior capsulotomy according to the type of intraocular lenses.

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Table 1.
Characteristics of patients
Parameters Values
Number of eyes 118
Gender (Male : female) 76 : 42
Age (years)
Mean ± SD 45.71 ± 5.01
Range 20 to 49
Preop. mean BCVA (log MAR) 0.57 ± 0.33
Postop. mean BCVA (log MAR) 0.14 ± 0.27
Mean follow up (months) 30.79 ± 13.21
Intraocular lens
I-FLEX 45
MI60 24
SN60WF 29
YA60BBR 20

Values are presented as mean ± SD.

able 2. Cumulative incidence of poste rior capsulotomy
Posterior capsulotomy rate (number [%])
months after phacoemulsification 5 (4.24)
months after phacoemulsification 6 (5.08)
2 months after phacoemulsification 10 (8.47)
4 months after phacoemulsification 19 (15.25)
More than 24 months (Total) 26 (20.34)
Table 3.
The Best Corrected Visual Acuity (BCVA) at the time of post-phacoemulsification, pre-capsulotomy, and post-capsu lotomy among patients with posterior capsulotomy
Post-phacoemulsification Pre-capsulotomy state Post-capsulotomy state
BCVA (log MAR) 0.23 ± 0.38 0.48 ± 0.36 0.22 ± 0.38

Values are presented as mean ± SD.

Table 4.
The rate of posterior capsulotomy according to the classification of cataract types
Cortical (n = 30) Nucleosclerosis (n = 9) Anterior subcapsular (n = 40) Posterior subcapsular (n = 30) Anterior & Posterior subcapsular, mixed (n = 5) Hypermature (n = 4)
Number (%) 4 (13.33) 4 (44.44) 9 (22.50) 7 (23.33) 1 (20.00) 1 (25.00)
Table 5.
Univariate subgroup analysis of risk factors of posterior capsulotomy in adults younger than 50 years according to the clas-sification of cataract types; compared with posterior subcapsular type group
Cataract type Odds ratio 95% CI p-value
Cortical type 1.248 0.357-4.358 0.728*
Nuclear type 4.492 1.258-16.038 0.021*
Anterior subcapsular type 0.742 0.254-2.162 0.584*
Anterior & posterior subcapsular type 2.672 0.315-22.687 0.368*
Mature type 20.832 1.837-236.247 0.014*

CI = confidence interval.

* Cox-regression analysis.

Table 6.
Number and rate of posterior capsulotomy according to the classification of intraocular lens
I-FLEX (n = 45) MI60 (n = 24) SN60WF (n = 29) YA60BBR (n = 20) p-value
Posterior capsulotomy (%) 16 (35.56) 4 (16.67) 2 (6.90) 4 (20.00) 0.028*

* Pearson's Chi-square test.

Table 7.
Multivariate analysis of risk factors of posterior cap-sulotomy in adults younger than 50 years
p-value*
Gender 0.729
DM 0.810
Glaucoma 0.667

* Pearson's Chi-square test.

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