Journal List > J Korean Ophthalmol Soc > v.56(6) > 1010299

Kim, Kim, Lee, and Kim: Incidence and Risk Factors of Nd:YAG Capsulotomy in Adult Cataract Patients under 50 Years of Age According to Different Age Groups

Abstract

Purpose

To evaluate the risk factors and incidence of neodymium-doped yttrium aluminium garnet (Nd:YAG) posterior capsulotomy due to posterior capsular opacification in adult cataract patients under 50 years of age according to different age groups.

Methods

We retrospectively studied 280 eyes that received phacoemulsification and intraocular lens implantation. The total observation period was 26.2 months on average. The subjects were divided into 3 different age groups, 20's, 30's and 40's to evaluate the incidence of posterior capsulotomy. Risk factors based on gender, age, type of cataract, type of intraocular lens (IOLs), axial length, existence of diabetes mellitus, history of ocular trauma, atopic dermatitis and refractive surgery were also inves-tigated using statistical analysis.

Results

The incidence of posterior capsulotomy was 13.9% (39 of 280 eyes) and statistically significant differences were not observed based on age (7.7% in the 20’s group, 13.8% in the 30’s group and 14.4% in the 40’s group, p=0.595). We divided subjects into 3 different groups based on axial length, below 22 mm, 22 to 26 mm and over 26 mm; posterior capsulotomy was performed in 0% (0/2), 7.2% (12/166) and 24.1% (27/112) of the patients, respectively, showing the longer axial length resulted in statistically significant increase in the incidence of posterior capsulotomy (p=0.036). The incidence of posterior capsulotomy was higher in females than in males (p=0.006). Correlations among posterior capsulotomy and type of cataract, type of IOLs and existence of diabetes mellitus, history of ocular trauma, atopic dermatitis and refractive surgery were not statistically significant.

Conclusions

The difference in the incidence of Nd:YAG laser posterior capsulotomy according to age was not statistically significant in adult cataract patients under 50 years of age. We showed that longer axial length resulted in higher risk of posterior capsulotomy.

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Table 1.
Patients’ clinical features and incidences of Nd:YAG capsulotomy according to multiple factors
  Total Non-capsulotomy Nd:YAG capsulotomy p-value
Total No. 280 241 (86.1) 39 (13.9)  
Gender (n, %)       0.006*
  Male 171 155 (87.5) 16 (9.3)  
  Female 109 86 (78.9) 23 (21.1)  
Age (years)       0.595
  Median 44.50 (20-49) 45 44  
  IQR 6.48 6.44 6.80  
  <30 years 13 12 (92.3) 1 (7.7)  
  30-39 years 58 50 (86.2) 8 (13.8)  
  40-49 years 209 179 (85.6) 30 (14.4)  
Axial length (mm)       <0.001
  <22 2 2 (100) 0 (0)  
  22-26 166 154 (92.8) 12 (7.2)  
  >26 112 85 (75.9) 27 (24.1)  
Anterior chamber depth (mm)       0.114
  Mean 3.23 3.22 3.34  
IOL       0.126*
  One-piece hydrophobic acrylic 140 126 (90.0) 14 (10.0)  
  One-piece hydrophilic acrylic 87 70 (80.5) 17 (19.5)  
  Three-piece hydrophobic acrylic 53 45 (84.9) 8 (15.1)  
Cataract type       0.057*
  Cortial opacity 53 44 (83.0) 9 (17.0)  
  Anterior subcapsular opacity 80 77 (96.3) 3 (3.7)  
  Anterior and posterior subcapsular opacity 23 19 (82.6) 4 (17.4)  
  Posterior subcapsular opacity 62 49 (79.0) 13 (21.0)  
  Nucleosclerosis 52 43 (82.7) 9 (17.3)  
  Mature cataract 10 9 (90.0) 1 (10.0)  
Diabetes 16 13 (81.2) 3 (18.8) 0.474§
Trauma history 9 7 (77.8) 2 (22.2) 0.363§
History of atopy 5 4 (80.0) 1 (20) 0.530§
History of refractive surgery 20 15 (75.0) 5 (25.0) 0.172§

Values are presented as n (%) unless otherwise indicated.

Nd:YAG= neodymium-doped yttrium aluminium garnet; IQR= interquartile range; IOL = intraocular lens.

* Pearson's chi-square test

Linear by linear association (chi-square test for trend)

Independent t-test

§ Fisher's exact test.

Table 2.
Multivariate Cox regression analysis of the factors associated with Nd:YAG capsulotomy
Variable Hazard ratio 95% CI p-value
Axial length 1.138 1.008-1.284 0.036*

Independent variables such as gender, age, diabetes, axial length, cataract type, and intraocular lens (IOL) type were included.

Nd:YAG= neodymium-doped yttrium aluminium garnet; CI= confidence interval.

* p<0.05.

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