Early-Onset Posterior Capsule Opacification: Incidence, Severity, and Risk Factors

Abstract

Introduction To evaluate the incidence, severity, and risk factors of early-onset posterior capsule opacification (PCO) following uneventful phacoemulsification and intraocular lens (IOL) implantation. Methods Patients with cataracts who underwent phacoemulsification and IOL implantation surgery for 3 months from September 2019 to April 2020 were enrolled. All the subjects completed a comprehensive ocular examination. Retroillumination images of the posterior capsule were obtained using a slit lamp with imaging system, and PCO was graded by two ophthalmologists. Univariate and multivariate logistic regression analyses were performed to assess the risk factors for PCO. Results A total of 1039 subjects were enrolled, with mean age 66.68 ± 11.43 years and 42.06% were male. The incidence of early-onset PCO in the 3 months after cataract surgery was 29.93%, and PCO of grade 3 and grade 4 was present in 31 patients (2.98%). Patients with complicated cataract had a higher incidence of PCO than age-related cataract, especially for patients with previous pars plana vitrectomy (PPV) surgery ( P < 0.001). Moreover, the incidence of PCO increased with the deficiency of capsulorhexis–IOL overlap ( P < 0.001). Multivariate logistic regression also showed that previous PPV surgery (OR 2.664, P = 0.003) and incomplete capsulorhexis–IOL overlap were risk factors for PCO (180–360° overlap: OR 2.058, P < 0.001; < 180° overlap: OR 5.403, P < 0.001). Conclusions Larger capsulorhexis and PPV surgery history contribute to the occurrence of early-onset PCO, indicating that primary posterior continuous curvilinear capsulorhexis can be considered during cataract surgery for patients with PPV history.

Posterior Capsule Opacification (PCO) Cases at Lamongan Eye Clinic: Two Years of Retrospective Data

“…Previous research [4], [10] found that most patients were in the age range of 41 years to 80 years, and Ayuningtyas et al [8] showed a median age of 65 years with a range of 42 years to 87 years. In various studies [11], [12], [13], [14], [15], [16] , the period between patients who underwent cataract surgery and PCO formation has been reported to occur from five months to three years. In this study, PCO diagnosis was established after a median of 12 months, ranging from 8.2 months to 26.3 months after cataract extraction.…”

Multiple linear regression model for improving accuracy of capsulorhexis size calculation in femtosecond laser-assisted cataract surgery for adults: a retrospective single-center study

“…They insisted that a capsulorhexis size of no more than 5.5 mm is desirable to prevent the development of PCO [ 2 ]. In addition, Gu et al demonstrated incomplete capsulorhexis–IOL overlap as a risk factor for PCO [ 15 ]. Aykan et al also reported a significant reduction in the incidence of PCO with complete capsulorhexis-IOL overlap [ 1 ].…”

Immediate sequential vs. delayed sequential bilateral cataract surgery: a systematic review and meta-analysis

“…5,17–20 The earliest measurement of both CDVA and SE was preferred to minimize the late postoperative effects of ocular comorbidities and posterior capsular opacification. 17,21,22…”

“…5,[17][18][19][20] The earliest measurement of both CDVA and SE was preferred to minimize the late postoperative effects of ocular comorbidities and posterior capsular opacification. 17,21,22 In terms of complications, the diagnosis of endophthalmitis was defined according to the definition provided in the Endophthalmitis Vitrectomy Study. 23 Persistent corneal edema was defined as the presence of a pseudophakic corneal edema and persistent endothelial cell damage within 30 days of surgery.…”