Article Text
Abstract
Background/aims To investigate the incidence of Nd:YAG-laser treatment for posterior capsular opacification (PCO) over a period of 5 years from phacoemulsification in an unselected population, comparing outcomes for three acrylic intraocular lenses (IOLs).
Methods Retrospective longitudinal cohort study comprising 900 eyes. Three subgroups of 300 eyes, receiving the AR40, AR40e (Abbott Medical Optics, Santa Ana, California), or BL27 (Bausch & Lomb, Rochester, New York) IOL respectively, were compared. Data on patient age, gender, IOL type, dates of cataract surgery, Nd:YAG-laser treatment and/or death, and visual acuities before/after cataract surgery/Nd:YAG-laser treatment were collected from five sources: cataract operation register, patient administration system, quality control system for cataract operations, Nd:YAG-laser treatment register and clinical patient records.
Results 216 eyes (24%) received Nd:YAG-laser treatment over a 5-year period. Statistically significant differences (p<0.001, χ2 test) were found between treatment rates for the three IOLs: AR40 73 eyes (24%), BL27 91 eyes (30%) and AR40e 52 eyes (17%). Eyes of patients who died during the follow-up period had fewer treatments (23/266, 8.6%) than eyes of patients living (193/634, 30%) at the end of the follow-up period.
Conclusion In comparison with a hydrophobic acrylic IOL with sharp posterior optic edge, a hydrophilic acrylic IOL was associated with almost twice the number of Nd:YAG-laser treatments over the 5-year period. The results are useful for discussing the economic long-term consequences of choosing an IOL with a design that makes PCO development more or less likely. Caution is advised when applying data from post-mortem PCO studies on living populations.
- Posterior capsular opacification
- phacoemulsification
- Nd-YAG lasers
- longitudinal survey
- retrospective study
This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: http://creativecommons.org/licenses/by-nc/2.0/ and http://creativecommons.org/licenses/by-nc/2.0/legalcode.
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Footnotes
Funding Kronprinsessan Margaretas Arbetsnämnd för synskadade (KMA), c/o Birgitta Lindgren, Fågelvägen 18, 645 40 Strängnäs, Sweden. Landstinget i Östergötland, SE 58185 Linköping, Sweden.
Competing interests The author is on the speaker’s list of Bausch & Lomb and as such has received reimbursement for expenses for several meetings. Bausch & Lomb provides financial and administrative support for research (not connected to the present paper). The author has no financial or other competing interests in any of the products or methods mentioned in the article.
Ethics approval Ethics approval was provided by The Regional Ethical Review Board in Linköping.
Provenance and peer review Not commissioned; externally peer reviewed.
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