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

Abstract

PurposeTo evaluate 3-year incidence of Nd:YAG capsulotomy and PCO and compare the effect of different IOL materials.MethodsData 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.ResultsThe 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.ConclusionsReal-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.

Evaluation of posterior capsule opacification of the Alcon Clareon IOL vs the Alcon Acrysof IOL using a human capsular bag model

“…In comparison to other currently available IOL models, the AcrySof model has shown a low incidence of PCO in many thousand eyes in several population based studies and meta-analyses [5,20]. Our study and other aforementioned, previous studies have shown a comparable performance of the Clareon and the Acry-Sof.…”

Pharmacoeconomic Analysis of Using Different Types of Monofocal Intraocular Lenses for Cataract Surgery in Russia

“…А также мультицентровое ретроспективное когортное исследование P. Ursell и соавт. [14], в рамках которого проводили оценку частоты проведения Nd:YAG-лазерной капсулотомии для лечения развившейся вторичной катаракты после ФЭК с последующей имплантацией ИОЛ в течение первых 3 лет после операции.…”

“…В крупном ретроспективном когортном исследовании P. Ursell и соавт. [14] проводили оценку возникновения вторичной катаракты после имплантации монофокальных ИОЛ различных производителей и частоты проведения по этому поводу Nd:YAGлазерной капсулотомии. Было выявлено, что при имплантации моноблочных монофокальных ИОЛ в течение 3 лет после проведения операции частота проведения Nd:YAGлазерной капсулотомии по поводу вторичной катаракты составила 2,4 % при имплантации гидрофобных ИОЛ на платформе AcrySof®, 5,1 % -при имплантации гидрофобных ИОЛ других производителей, 10,9 % -при имплантации гидрофильных ИОЛ различных производителей.…”

“…3-й вариант Взрослому пациенту с катарактой в ходе хирургического лечения имплантируют гидрофильную ИОЛ любого из анализируемых производителей, в течение 3 лет после операции частота развития вторичной катаракты, требующей хирургического лечения, составляет 10,9 % [14].…”

The Effect of Capsulotomy Shape on Intraocular Light-Scattering after Nd:YAG Laser Capsulotomy

“…Schaumberg et al [2] showed that the incidences of PCO at 1, 3, and 5 years after cataract surgery are 11.8%, 20.7%, and 28.4%, respectively. Ursell et al [3] followed up 13,329 eyes implanted with AcrySof IOL, 19,025 eyes implanted with non-AcrySof hydrophobic IOL, and 19,808 eyes implanted with non-AcrySof hydrophilic IOL for 3 years and found a 3year incidence of PCO and Nd:YAG capsulotomy ranging from 4.7% to 14.8% according to the different IOL materials used. Ambroz et al [4] found PCO in 30.9% of the surveyed eyes at 18.4-50.2 months after pediatric cataract surgery.…”