Comparison of Nd:YAG Laser Capsulotomy Rates between Implantation of Two Different Aspheric Intraocular Lenses

Sung Hyun Kim; Choul Yong Park

doi:10.3341/jkos.2015.56.2.190

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Kim and Park: Comparison of Nd:YAG Laser Capsulotomy Rates between Implantation of Two Different Aspheric Intraocular Lenses

Original Article

J Korean Ophthalmol Soc 2015;56(2):190-198.

Published online: 6 September 2015

DOI: https://doi.org/10.3341/jkos.2015.56.2.190

Comparison of Nd:YAG Laser Capsulotomy Rates between Implantation of Two Different Aspheric Intraocular Lenses

Sung Hyun Kim, MD, Choul Yong Park, MD, PhD

Department of Ophthalmology, Dongguk University Ilsan Hospital, Dongguk University College of Medicine, Goyang, Korea

Address reprint requests to Choul Yong Park, MD, PhD, Department of Ophthalmology, Dongguk University Ilsan Hospital, #27 Dongguk-ro, Ilsandong-gu, Goyang 410-773, Korea, Tel: 82-31-961-7395, Fax: 82-31-961-7977 E-mail: oph0112@gmail.com

Received 1 May 201410 August 2014 Accepted 28 January 2015

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 compare neodymium-doped yttrium aluminum garnet (Nd:YAG) laser capsulotomy rates between 2 different aspheric intraocular lenses, SN60WF and MI-60, in patients who underwent cataract surgery.

Methods

This retrospective study included 404 eyes of 278 patients who were followed up for at least 6 months after cataract surgery. Gender, age, follow-up period and Nd:YAG laser capsulotomy rates between the 2 different intraocular lens groups were compared.

Results

The mean follow-up period was 28.1 months in the SN60WF group and 24.3 months in the MI-60 group and the mean age was 68.6 years and 71.3 years in each group, respectively. Follow-up period and age were significantly different between the 2 groups (p < 0.01). Nd:YAG laser capsulotomy rates were 5.6% (13 of 231 eyes) in the SN60WF group and 48% (83 of 173 eyes) in the MI-60 group. Nd:YAG laser capsulotomy rates were significantly higher in the MI-60 group (p < 0.01). Female gender and young age were associated with significantly increased Nd:YAG laser capsulotomy rates (p < 0.01); however, diabetes mellitus was not significantly associated with Nd:YAG laser capsulotomy rates.

Conclusions

Nd:YAG laser capsulotomy rates were higher in the MI60 hydrophilic aspheric intraocular lens group than the SN60WF hydrophilic aspheric intraocular lens group.

Keywords: Hydrophilic, Hydrophobic, Intraocular lens, Nd, YAG laser capsulotomy, Posterior capsular opacity

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Figure 1.

Percentage of eyes without neodymium-doped yt-trium aluminum garnet (Nd:YAG) laser capsulotomy after cataract surgery. Nd:YAG laser capsulotomy rates after cataract surgery were increased as time goes by. Since post-operative 6 months, Nd:YAG laser capsulotomy rates were statistically significant different between eyes with MI60 and eyes with SN60WF (p<0.01). At postoperative 31.8 months, Nd:YAG laser capsulotomy rates were 43% in eyes with MI60 and 3.5% in eyes with SN60WF. IOL = intraocular lens.

Table 1.

Properties of intraocular lens used in this study

Characteristics	Akreos®MI60	Acrysof®IQ SN60WF
Lens	1-piece	1-piece
Optic sphericity	Aspherical	Aspherical
Optic type	Monofocal	Monofocal
Optical material	Hydrophilic acrylic	Hydrophobic acrylic
Optic size (mm)	5.6-6.2	6
Overall length (mm)	10.5-11.0	13
Material	Hydrophilic acrylic	Hydrophobic acrylic
Posterior optic edge design	Square edge	Square edge
Haptic design	Plate-haptic	Loop

Table 2.

Comparison of characteristics between the 2 intraocular lens groups

	Akreos®MI60	Acrysof®IQ SN60WF
Follow-up period (months)	24.3 ± 10.8 (6.3-42.1)	28.1 ± 16.0 (6.2-65.2)
	^∗ p < 0.01
Age (years)	68.6 ± 10.6 (37-94)	71.3 ± 9.40 (39-96)
	^∗ p < 0.01
Sex (M/F)	68/105	84/147
	^† p > 0.05

Values are presented as mean ± SD unless otherwise indicated.

^∗ Independent t-test

^† Chi-square test.

Table 3.

Clinical characteristics of eyes with or without Nd:YAG laser capsulotomy

	Patients with Nd:YAG laser capsulotomy (n = 96)	Patients without Nd:YAG laser capsulotomy (n = 308)	p-value
Age (years)	65.4 ± 10.5 (37-83)	71.6 ± 9.3 (39-96)	^∗<0.01
Sex (%)
Male	29 (19.1)	123 (80.9)	^†>0.05
Female	67 (26.6)	185 (60.1)
DM (%)
With DM	31 (22.5)	107 (77.5)	^†>0.05
Without DM	65 (24.4)	201 (75.6)
IOL (%)
Acrysof SN60WF IOL	13 (5.6)	218 (94.4)	^†<0.01
Akreos MI60 IOL	83 (48.0)	90 (52.0)

Values are presented as mean ± SD unless otherwise indicated. Nd:YAG = neodymium-doped yttrium aluminum garnet; DM = diabetes mellitus; IOL = intraocular lens.

^∗ Independent t-test

^† Chi-squared test.

Table 4.

Multivariate logistic regression analysis of Nd:YAG laser capsulotomy

	OR	95% CI	p-value
IOL (Akreos MI60)	16.320	8.433-31.580	^∗<0.01
Age (young age)	1.065	1.036-1.096	^∗<0.01
Sex (female)	2.105	1.168-3.788	^∗<0.01
DM	1.023	0.569-1.839	^∗>0.05

Nd:YAG = neodymium-doped yttrium aluminum garnet; OR = odds ratio; CI = confidence interval; IOL = intraocular lens; DM = diabetes mellitus.

^∗ Binominal logistic regression analysis.

Table 5.

Effects of intraocular lens optic design (sharp posterior optic edge versus round posterior optic edge), haptics (1-piece versus 3-piece), sphericity (aspheric versus spheric), material (PMMA versus silicone versus acrylic, hydrophilic acrylic versus hydrophobic acrylic) on development of posterior capsule opacification or Nd:YAG laser capsulotomy rates

	PCO value (score)/ Capsulotomy rates (%)	Follow-up period	p-value	Study ID
Optic design (sharp posterior optic edge versus round posterior optic edge)
Sharp edge	^*0.145 ± 0.27	14.01 ± 2.81	<0.01	Auffarth et al³⁷
Round edge	^*0.55 ± 0.28
Haptics (1-piece versus 3-piece)
1-piece	^†0.2 ± 0.5	12	>0.05	Prinz et al²²
3-piece	^†0.3 ± 0.5
1-piece	*0.2 ± 0.23	24	>0.05	Wallin et al²⁴
3-piece	^∗0.11 ± 0.23
1-piece	^†1.5	24	>0.05	Sacu et al³⁸
3-piece	^†1.3
Sphericity (aspheric versus spheric)
Aspheric	1.8%	6	>0.05	Jun et al²⁰
Spheric	3.2%
Aspheric	17.3%	15.9 ± 6.5	<0.01	Biber et al³⁹
Spheric	4.0%
Material (PMMA versus silicone versus acrylic)
PMMA	30.4%	24	<0.01 (PMMA versus	Hayashi et al⁴⁰
Silicone	5.7%		silicone, PMMA versus acrylic)
Acrylic	2.7%		>0.05 (silicone versus acrylic)
Material (hydrophilic acrylic versus hydrophobic acrylic)
Hydrophilic acrylic	^‡50.3	12	<0.01	Heatley et al¹⁰
Hydrophobic acrylic	‡4.9
Hydrophilic acrylic	10%	24	<0.01	Kugelberg et al¹²
Hydrophobic acrylic	42%

Values are presented as mean ± SD unless otherwise indicated. Nd:YAG = neodymium-doped yttrium aluminum garnet; PCO = posterior capsule opacification; PMMA = polymethylmethacrylate.

^∗ Values are estimated by EPCO (Established image analysis system)

^† Values are estimated by AQUA (Automated Quantification of After-catarct)

^‡ Values are estimated by POCO (posterior capsule opacification software).

Table 6.

Studies about effects of hydrophilic acrylic versus hydrophobic acrylic intraocular lens on development of posterior capsule opacification and Nd:YAG laser capsulotomy in Korea

	PCO development (%)	Nd:YAG laser capsulotomy rates (%)	Follow-up periods (months)	p-value	Study ID
Hydrophilic acrylic	29.3	20.3	36	<0.01	Suh et al¹⁸
Hydrophobic acrylic	13.5	6.8
Hydrophilic acrylic		35.56, 16.67, 20	24	<0.01	Yoo et al⁴¹
Hydrophobic acrylic		6.9

Nd:YAG = neodymium-doped yttrium aluminum garnet; PCO = posterior capsule opacification.

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