Retrospective Study
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World J Ophthalmol. Aug 12, 2014; 4(3): 82-86
Published online Aug 12, 2014. doi: 10.5318/wjo.v4.i3.82
Cumulative probability and risk analysis for Nd:YAG laser capsulotomy
Anna K Junk, Evan N Dunn, Anat Galor, Sarah R Wellik, Jesse Pelletier, Ninel Gregori, William Feuer
Anna K Junk, Anat Galor, Sarah R Wellik, Ninel Gregori, Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami VAMC, Miami, FL 33136, United States
Evan N Dunn, Jesse Pelletier, Ophthalmology, Miami VAMC, Miami, FL 33136, United States
William Feuer, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL 33136, United States
Author contributions: All authors ​​contributed to this article.
Supported by In part by NEI Core Center, No. P30 EY014801; Research to Prevent Blindness (RPB) Unrestricted Award and Department of Defense; No. #W81XWH-09-1-0675; VA Career Development Award (CDA2) and Stanley Glaser UM to Dr. Anat Galor
Correspondence to: Anna K Junk, MD, Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami VAMC, 900 NW 17th St, Miami, FL 33136, United States. ajunk@med.miami.edu
Telephone: +1-305-3266000 Fax: +1-305-4824568
Received: February 8, 2014
Revised: July 4, 2014
Accepted: August 10, 2014
Published online: August 12, 2014
Processing time: 253 Days and 9.7 Hours
Abstract

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.

Keywords: YAG capsulotomy; Posterior capsule opacification; Cataract surgery; Risk factor; Surgeon experience; Cumulative probability; Teaching institution

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.