Incidence and Risk Factors of Nd:YAG Capsulotomy in Adult Cataract Patients Younger than 50 Years of Age

Young Sik Yoo; Ji Wook Yang; Young Chun Lee; Su Young Kim

doi:10.3341/jkos.2013.54.9.1339

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

Original Article

J Korean Ophthalmol Soc 2013;54(9):1339-1344.

Published online: 7 September 2013

DOI: https://doi.org/10.3341/jkos.2013.54.9.1339

Incidence and Risk Factors of Nd:YAG Capsulotomy in Adult Cataract Patients Younger than 50 Years of Age

Young Sik Yoo, MD, Ji Wook Yang, MD, Young Chun Lee, MD, PhD, Su Young Kim, MD, PhD

Department of Ophthalmology & Visual Science College of Medicine, The Catholic University of Korea, Seoul, Korea

Address reprint requests to Su Young Kim, MD, PhD The Catholic University of Korea, Uijeongbu St. Mary’s Hospital, #271 Cheonbo-ro, Uijeongbu 480-717, Korea Tel: 82-31-820-3110, Fax: 82-31-847-3418 E-mail: cassiopeia-su@hanmail.net

Received 5 October 20127 February 2013 Accepted 1 June 2013

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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.

Keywords: Adult cataract, Nd, YAG capsulotomy, Posterior capsular opacity

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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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