Published online Aug 12, 2014. doi: 10.5318/wjo.v4.i3.82
Revised: July 4, 2014
Accepted: August 10, 2014
Published online: August 12, 2014
AIM: To estimate the cumulative probability of Nd:YAG capsulotomy at a teaching institution and evaluate secondary risk factors.
METHODS: The records of all patients who underwent phacoemulsification with intraocular lens (IOL) placement between 2005-2010 were retrospectively reviewed. The cumulative probability of Nd:YAG capsulotomy (capsulotomy) was calculated using Kaplan-Meier survival analysis and secondary risk factors were evaluated using the Cox proportional hazards regression model.
RESULTS: One thousand three hundred and fifty four charts were reviewed. A total of 70 capsulotomies were performed. The mean follow-up was 19.4 mo (standard deviation 17 mo). The cumulative probability of capsulotomy was 4% at 1 year, 5% at 2 years, and 9% at 3 years. Multivariate analysis demonstrated an increased risk with younger age (HR = 1.03, CI 1.01-1.05, P = 0.007), placement of sulcus IOL (HR = 2.57, CI 1.32-4.99, P = 0.005), ocular trauma (HR = 2.34, CI 1.13-4.83, P = 0.02), and phacoemulsification by a more experienced surgeon (HR = 4.32, CI 1.89-9.87, P = 0.001).
CONCLUSION: Cumulative probability of capsulotomy was lower than previously reported. Posterior capsule opacification was strongly associated with younger age and factors associated with high-risk cataract surgery. Surgeon awareness to the risk factors that correlate with posterior capsulotomy may allow for more thorough pre-operative disclosure and enhance patient satisfaction.
Core tip: Posterior capsule opacification (PCO) is a known late sequelae of cataract surgery. Our study uncovers risk of PCO in teaching institutions is associated with surgeon experience in that YAG capsulotomy rates are higher in patients whose cataract surgery was performed by a more experienced surgeon. Capsulotomy rates overall were lower than previously reported.