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

Eun Yeong Kim; Sun Young Kim; Young Chun Lee; Su Young Kim

doi:10.3341/jkos.2015.56.6.868

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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

Original Article

J Korean Ophthalmol Soc 2015;56(6):868-874.

Published online: 7 September 2015

DOI: https://doi.org/10.3341/jkos.2015.56.6.868

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

Eun Yeong Kim, MD, Sun Young Kim, MD, Young Chun Lee, MD, PhD, Su Young Kim, MD, PhD

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

Address reprint requests to Su Young Kim, MD. PhD. Department of Ophthalmology, The Catholic University of Korea Uijeongbu St. Mary's Hospital, #271 Cheonbo-ro, Uijeongbu 480-717, Korea, Tel: 82-31-820-3587, Fax: 82-31-847-3418 E-mail: cassiopeia-su@hanmail.net

Received 8 November 201415 February 2015 Accepted 6 May 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 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.

Keywords: Axial length, Nd, YAG laser capsulotomy, Posterior capsular opacification

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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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