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Evaluation of Nd:YAG Laser Capsulotomy Rates in a Real-Life Population

Authors Ling R, Borkenstein EM, Borkenstein AF

Received 13 August 2020

Accepted for publication 5 October 2020

Published 13 October 2020 Volume 2020:14 Pages 3249—3257


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 4

Editor who approved publication: Dr Scott Fraser

Roland Ling,1 Eva-Maria Borkenstein,2 Andreas F Borkenstein2

1The Medical Eye Clinic, Royal Devon and Exeter Hospital, Exeter, UK; 2Privatklinik der Kreuzschwestern Graz, Private Practice Borkenstein & Borkenstein, Graz, Austria

Correspondence: Andreas F Borkenstein
Privatklinik der Kreuzschwestern Graz, Private Practice Borkenstein & Borkenstein, Graz 8010, Austria
Tel +43 316 331 3880

Objective: The objective of this study was to assess the rate of posterior capsule opacification (PCO), under “real-life” conditions, as measured by rates of Nd:YAG laser intervention, rather than from a controlled study from which patients with conditions predisposing to PCO have been excluded.
Methods and Analysis: This was a retrospective, multicenter study in an unselected consecutive cohort of patients undergoing surgery for senile cataract. Patients aged 18 years and older, previously implanted with the CT LUCIA 611P IOL, were contacted at 12, 18 and 24 months to ascertain if they had received Nd:YAG laser treatment. There was an additional assessment at 36 months at the Austrian centre.
Results: A total of 200 patients were recruited at two centers. Laser capsulotomy rates were 4.5% at 1 year and 10% by year 2 and 12% by year 3. Three Nd:YAG capsulotomies, carried out at other external centers, were performed for reasons other than PCO, including astigmatism, epiretinal membrane and ARMD. If these patients are excluded, the true rate of Nd:YAG carried out for PCO at 1 year was 3.5% and at 2 years was 8.5%.
Conclusion: It is critical to ensure that Nd:YAG capsulotomies are being performed only for the correct clinical reason. Carrying out unnecessary procedures places the patient at risk of adverse events, is a cost to the healthcare system, and is likely to have no direct visual benefit for the patient. In PCO studies, it should be a requirement to document the fibrosis grade to confirm that Nd:YAG capsulotomy was correctly indicated.

Keywords: Nd:YAG laser capsulotomy, PCO, cataract, CT LUCIA 611P

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