The Influence of Vitrectomy of Nd:YAG Laser Posterior Capsulotomy

Jin Cheol Lee; Yu Cheol Kim

doi:10.3341/jkos.2014.55.12.1787

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Lee and Kim: The Influence of Vitrectomy of Nd:YAG Laser Posterior Capsulotomy

Original Article

J Korean Ophthalmol Soc 2014;55(12):1787-1792.

Published online: 2 September 2014

DOI: https://doi.org/10.3341/jkos.2014.55.12.1787

The Influence of Vitrectomy of Nd:YAG Laser Posterior Capsulotomy

Jin Cheol Lee, MD, Yu Cheol Kim, MD

Department of Ophthalmology, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea

Address reprint requests to Yu Cheol Kim, MD, Department of Ophthalmology, Keimyung University Dongsan Medical Center, #56 Dalseong-ro, Jung-gu, Daegu 700-712, Korea, Tel: 82-53-250-7707, 8026, Fax: 82-53-250-7705, E-mail: eyedr@dsmc.or.kr

Received 29 August 2014 Revised 16 October 2014 Accepted 17 November 2014

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

This study aimed to investigate factors that cause after-cataract such as diabetes, intravitreal gas injection during vitrectomy, and other factors in relation to the vitrectomy.

Methods

The relationship between the vitrectomy and the frequency of Nd:YAG laser posterior capsulotomy was investigated in a sample of 947 monitored patients’ eyes that underwent cataract surgery. The patients’ eyes were classified into Group 1, which comprised 715 patients’ eyes that underwent cataract surgery only, Group 2, which comprised 152 eyes that underwent both vitrectomy and cataract surgery at the same time, and Group 3, which comprised 80 eyes that underwent cataract surgery after vitrectomy. The age, gender, diabetes status, gases injected during the vitrectomy, and other factors were investigated.

Results

It was found that 50 eyes (6.99%) in Group 1 received the posterior capsulotomy, 28 eyes (18.4%) had the procedure in Group 2, and 16 eyes (20.00%) had the procedure in Group 3, respectively. In Group 1, 21 eyes (8.86%) that received the posterior capsulotomy were from diabetic patients, 20 eyes (19.8%) were diabetic in Group 2, and 10 eyes (21.73%) were diabetic in Group 3. In Group 1, 29 eyes (6.06%) were from non-diabetics that received posterior capsulotomy, 8 eyes (15.68%) were from non-diabetic patients in Group 2, and 6 eyes (17.64%) were from non-diabetic patients in Group 3. In the group that had vitrectomy with gas injection, 6 eyes (25%) received the posterior capsulotomy in Group 2, and 10 eyes (24.39%) had the procedure in Group 3, respectively, while those in the group that had vitrectomy without gas injection included 22 eyes (17.46%) in Group 2 and 6 eyes (15.38%) in Group 3.

Conclusions

The Nd:YAG laser posterior capsulotomy was more frequently applied to patients who underwent vitrectomy, younger patients, diabetes patients, and patients who had vitrectomy with gas injection.

Keywords: After-cataract, Nd:YAG laser posterior capsulotomy, Pars plana vitrectomy

References

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Table 1.

Comparison of clinical characteristics each group

	Group 1	Group 2	Group 3	p-value^*
No. of eyes	715	152	80	−
Sex (M:F)	336:379	72:80	43:37	0.23
Age (years)	60.17 ± 12.46	66.17 ± 7.26	65.68 ± 8.13	0.58

Values are presented as mean ± SD unless otherwise indicated; Group 1: Undergone only cataract surgery; Group 2: Undergone cataract surgery with vitrectomy; Group 3: Undergone cataract surgery after vitrectomy.

^* Analyzed with ANOVA t-test.

Table 2.

Incidence of YAG laser capsulotomy according to vitrectomy surgery

	Group 1	Group 2 + Group 3		p-value^*
	Group 1	Group 2	Group 3	p-value^*
Incidience of YAG laser capsulotomy (%)	6.99 (50/715)	18.96 (44/232)		0.017
		18.40 (28/152)	20.00 (16/80)	0.026	0.011

Group 1: Undergone only cataract surgery; Group 2: Undergone cataract surgery with vitrectomy; Group 3: Undergone cataract surgery after vitrectomy.

^* Analyzed with Pearson chi-square test, statistically significant (p < 0.05).

Table 3.

Incidence of YAG laser capsulotomy according to undergone vitrectomy surgery at the same time or after cataract surgery

	Group 2	Group 3	p-value^*
Incidience of YAG laser capsulotomy (%)	18.40 (28/152)	20.00 (16/80)	0.042

Group 2: Undergone cataract surgery with vitrectomy; Group 3: Undergone cataract surgery after vitrectomy.

^* Analyzed with Pearson chi-square test, statistically significant (p < 0.05).

Table 4.

Incidence of YAG laser capsulotomy according to diabetic and non-diabetic

	DM (+)^*	DM (-)^†	p-value^‡
Group 1 (%)	8.86 (21/237)	6.06 (29/478)	0.048
Group 2 (%)	19.80 (20/101)	15.68 (8/51)	0.023
Group 3 (%)	21.73 (10/46)	17.64 (6/34)	0.037

Group 1: Undergone only cataract surgery; Group 2: Undergone cataract surgery with vitrectomy; Group 3: Undergone cataract surgery after vitrectomy.

DM = diabetes mellitus.

^* Diabetic;

^† Non-diabetic;

^‡ Analyzed with Wilcoxon signed rank test, statistically significant (p < 0.05).

Table 5.

Incidence of YAG laser capsulotomy according to intravitreal gas tamponade on vitrectomy surgery

	Gas (+)	Gas (-)	p-value^*
Group 2 (%)	25.00 (6/26)	17.46 (22/126)	0.025
Group 3 (%)	24.39 (10/41)	15.38 (6/39)	0.019
Group 2 + Group 3 (%)	23.88 (16/67)	19.97 (28/165)	0.045

Group 2: Undergone cataract surgery with vitrectomy; Group 3: Undergone cataract surgery after vitrectomy.

^* Analyzed with Wilcoxon signed rank test, statistically significant (p < 0.05).

Table 6.

Comparison of follow-up period until YAG laser capsulotomy for after-cataract

	Group 1	Group 2	Group 3	p-value^*
Period until YAG laser capsulotomy after cataract surgery (months)	30.07	28.55	26.98	0.098

Group 1: Undergone only cataract surgery; Group 2: Undergone cataract surgery with vitrectomy; Group 3: Undergone cataract surgery after vitrectomy.

^* Analyzed with ANOVA t-test.

Table 7.

Incidence of YAG laser capsulotomy according undergone vitrectomy surgery at the same time or after cataract surgery with or without diabetes

	DM (+)^*	DM (-)^†
Group 2 (%)	19.80 (20/101)	15.68 (8/51)
Group 3 (%)	21.73 (10/46)	17.64 (6/34)
p-value^‡	0.042	0.040

Group 2: Undergone cataract surgery with vitrectomy; Group 3: Undergone cataract surgery after vitrectomy.

DM = diabetes mellitus.

^* Diabetic;

^† Non-diabetic;

^‡ Analyzed with Pearson chi-square test, statistically significant (p < 0.05).

Table 8.

Incidence of YAG laser capsulotomy according to undergone intravitreal gas tamponade on vitrectomy surgery at the same time or after cataract surgery

	Gas (+)	Gas (-)
Group 2 (%)	25.00 (6/26)	17.46 (22/126)
Group 3 (%)	24.39 (10/41)	15.38 (6/39)
p-value^*	0.063	0.057

Group 2: Undergone cataract surgery with vitrectomy; Group 3: Undergone cataract surgery after vitrectomy.

^* Analyzed with Pearson chi-square test.

Table 9.

Incidence of YAG laser capsulotomy according to ages

	Group 1 (%)	Group 2 (%)	Group 3 (%)	Total (%)
Age (years)
<50	15.22 (7/46)	16.67 (1/6)	25.00 (1/4)	16.07 (9/56)
50-59	9.30 (8/86)	12.90 (4/31)	21.05 (4/19)	11.76 (16/136)
60-69	5.14 (9/175)	12.73 (7/55)	20.69 (6/29)	8.49 (22/259)
≥70	6.37 (26/408)	13.11 (8/61)	17.86 (5/28)	7.85 (39/497)
p-value^*	0.087	0.137	0.048^†	0.023^†

Group 1: Undergone only cataract surgery; Group 2: Undergone cataract surgery with vitrectomy; Group 3: Undergone cataract surgery after vitrectomy.

^* Analyzed with ANOVA test;

^† Statistically significant (p < 0.05).

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