Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Oct;32(10):1579-1589.
doi: 10.1038/s41433-018-0131-2. Epub 2018 Jun 11.

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

Paul G Ursell  1 , Mukesh Dhariwal  2 , Katarina Majirska  3 , Frank Ender  4 , Shoshannah Kalson-Ray  5 , Alessandra Venerus  5 , Cristiana Miglio  5 , Christine Bouchet  6
Affiliations

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

Paul G Ursell et al. Eye (Lond). 2018 Oct.

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.

PubMed Disclaimer

Conflict of interest statement

MD is an employee of Novartis. KM, FE and CB are employees of Alcon, the study sponsor. SK-R, AV and CM, are employees of IQVIA, the company contracted by Alcon Laboratories to conduct the study. PGU received consulting fees and travel grant from Alcon.

Figures

Fig. 1
Fig. 1
Population selection and attrition for eyes included in the study
Fig. 2
Fig. 2
Incidence proportions of Nd:YAG capsulotomy at 1, 2 and 3 years following cataract surgery for eyes implanted with AcrySof, non-AcrySof hydrophobic and non-AcrySof hydrophilic IOLs. Figure 2a includes both single and multi-piece IOLs, Fig. 2b includes single-piece IOLs only
Fig. 3
Fig. 3
Kaplan–Meier survival plots of eyes implanted with AcrySof, non-AcrySof hydrophobic and non-AcrySof hydrophilic IOLs and not requiring Nd:YAG capsulotomy over 3 years following cataract surgery. Curves represent the survival estimates with number of subjects at risk and 95% Hall–Wellner Bands. Figure 3a includes both single and multi-piece IOLs, Fig. 3b includes single-piece IOLs only
Fig. 4
Fig. 4
Adjusted ORs of undergoing Nd:YAG capsulotomy over 3 years from cataract surgery for eyes implanted with non-AcrySof hydrophobic and hydrophilic versus AcrySof IOLs. Multivariate logistic regression with level of significance = 0.05. ORs > 1 indicate that the comparator cohort is protective against Nd:YAG capsulotomy. a includes both single and multi-piece IOLs, b includes single-piece IOLs only
Fig. 5
Fig. 5
Incidence proportions of PCO at 1, 2 and 3 years following cataract surgery for eyes implanted with AcrySof, non AcrySof hydrophobic and non-AcrySof hydrophilic IOLs
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Raj SM, Vasavada AR, Johar SRK, Vasavada VA, Vasavada VA. Post-operative capsular opacification: a review. Int J Biomed Sci Master Publ Group. 2007;3:237–50. - PMC - PubMed
    1. Vasavada A, Shetal MR, Shah GD, Nanavaty MA. Posterior Capsule Opacification After Lens Implantation. Expert Rev Ophthalmol. 2013;8:141–9. doi: 10.1586/eop.12.80. - DOI
    1. Boureau C, Lafuma A, Jeanbat V, Smith AF, Berdeaux G. Cost of cataract surgery after implantation of three intraocular lenses. Clin Ophthalmol. 2009;3:277–85. - PMC - PubMed
    1. Buehl W, Findl O. Effect of intraocular lens design on posterior capsule opacification. J Cataract Refract Surg. 2008;34:1976–85. doi: 10.1016/j.jcrs.2008.07.029. - DOI - PubMed
    1. Kobayashi H, Ikeda H, Imamura S, Kobayashi K, Mitsuma Y, Minami M, et al. Clinical assessment of long-term safety and efficacy of a widely implanted polyacrylic intraocular lens material. Am J Ophthalmol. 2017;130:310–21. doi: 10.1016/S0002-9394(00)00490-6. - DOI - PubMed

Publication types

MeSH terms

LinkOut - more resources