Posterior capsule opacification treatment using Nd: YAG laser capsulotomy: 36 months retrospective analysis.

Background: The study aimed to identify factors influencing the time from cataract surgery to PCO treatment with Neodymium: Yttrium-Aluminium-Garnet (Nd: YAG) laser.

Methods: For PCO risk factors analysis the retrospective study included 1045 eyes treated for PCO using Nd: YAG laser capsulotomy in the Hospital of Lithuanian University of Health Sciences (HLUHS) Kaunas Clinics with reduced best-corrected distance visual acuity (BCDVA) and opacity in the central 3 mm zone. Eyes with no comorbidities were categorized into groups according to the intraocular lense (IOL) implanted and the time from cataract operation to Nd: YAG capsulotomy was compared. Tests used for statistical analysis: Shapiro-Wilk, Kruskal-Wallis, Mann-Whitney, one-way independent ANOVA, Pearson's or Spearman's correlation coefficient, and multivariable linear regression.

Results: A total of 918 patients (1045 eyes) were included. The median time from cataract surgery to capsulotomy was 39.0 (27.4-54.6) months (min. 2; max. 174), did not differ between men and women, and was shorter for junior surgeons (25.8 (19.8-35.1) months) compared to senior surgeons (39.6 (27.8-55.3) months) (p < 0.001). Seven factors affecting the time from cataract surgery to Nd: YAG capsulotomy were found: IOL model, surgeon's experience, BCDVA after surgery, capsular tension ring, pseudoexfoliation, BCDVA before capsulotomy and exudative age-related macular degeneration (adjusted R2 = 0.452; p < 0.001). The IOL model was the only factor with a strong correlation. The median time from cataract surgery to capsulotomy differed between all IOL groups: Acriva UD613 group 31.5 (23.0-38.0) months, Johnson&Johnson Tecnis ZCB00 group 41.0 (33.5-66.5) months, Bausch&Lomb Envista MX60 group 45.0 (38.5-54.5) months, and Alcon Acrysof IQ SN60WF group 53.0 (41.5-79.5) months.

Conclusions: The IOL model seems to have the greatest influence on the time from cataract surgery to Nd: YAG capsulotomy. Acrylic hydrophobic IOLs with a square optical edge have different times from cataract surgery to Nd: YAG capsulotomy. Hydrophobic acrylic IOL seems to have a longer time from cataract surgery to Nd: YAG capsulotomy compared to hydrophilic acrylic IOL with a hydrophobic surface.