Three-year incidence of Nd:YAG capsulotomy and posterior capsule opacification and its relationship to monofocal acrylic IOL biomaterial: a UK Real World Evidence study. (October 2018)

• Record Type: Journal Article
• Authors: Ursell, Paul; Dhariwal, Mukesh; Majirska, Katarina; Ender, Frank; Kalson-Ray, Shoshannah; Venerus, Alessandra; Miglio, Cristiana; Bouchet, Christine
• Is Part Of: Eye. Volume 32:Number 10(2018)
• Page Start: 1579
• Page End: 1589
• Publication Date: 2018-10
• Subjects: Ophthalmology -- Periodicals
• DOI: 10.1038/s41433-018-0131-2
• Languages: English
• ISSNs: 0950-222X

Abstract

Abstract Purpose To evaluate 3-year incidence of Nd:YAG capsulotomy and PCO and compare the effect of different IOL materials. Methods Data were retrospectively collected from seven UK ophthalmology clinics using Medisoft electronic medical records. Eyes from patients ≥65 years undergoing cataract surgery with implantation of acrylic monofocal IOLs during 2010–2013 and 3-year follow-up were analysed. Nd:YAG capsulotomy and PCO incidence proportions were reported for 3 IOL cohorts: AcrySof, other hydrophobic and hydrophilic acrylic IOLs. Unadjusted/adjusted odds ratios (OR) of Nd:YAG capsulotomy were calculated through logistic regression for non-AcrySof cohorts versus AcrySof. A sub-group analysis in single-piece IOLs (>90% of sample eyes) was also performed. Results The AcrySof cohort included 13, 329 eyes, non-AcrySof hydrophobic 19, 025 and non-AcrySof hydrophilic 19, 808. The 3-year Nd:YAG capsulotomy incidence (95% CI) for AcrySof (2.4%, 2.2–2.7%) was approximately two times lower than non-AcrySof hydrophobic IOLs (4.4%, 4.1–4.7%) and approximately fourfold lower than non-AcrySof hydrophilic IOLs (10.9%, 10.5–11.3%). Trends were similar in PCO incidence (AcrySof: 4.7%; non-AcrySof hydrophobic: 6.3%; non-AcrySof hydrophilic: 14.8%). Also in the analysis restricted to single-piece IOLs, the pattern remained (2.4% vs 5.1% vs. 10.9%, respectively). Adjusted regression analysis showed a approximately two and fivefold increased odds of Nd:YAG for non-AcrySof hydrophobic and hydrophilic acrylic IOLs respectively vs. AcrySof IOLs. Nd:YAG capsulotomy ORs were similar and remained statistically significant in the single-piece IOL sub-group. Conclusions Real-world evidence shows that within 3 years following implantation, AcrySof IOLs are significantly superior in reducing Nd:YAG capsulotomy and PCO incidence compared to other hydrophilic and hydrophobic acrylic IOLs.