Incidence of Retinal Detachment, Macular Edema, and Ocular Hypertension after Neodymium:Yttrium-Aluminum-Garnet Capsulotomy: A Population-Based Nationwide Study-The French YAG 2 Study.
| Autor: | Dot C; Department of Ophthalmology, Desgenettes Military Hospital, Lyon, France. Electronic address: corinnedot.pro@hotmail.fr., Schweitzer C; CHU Bordeaux, Department of Ophthalmology, University of Bordeaux, ISPED, INSERM, U1219-Bordeaux Population Health Research Centre, Bordeaux, France., Labbé A; Department of Ophthalmology, Quinze-Vingts National Ophthalmology Hospital, Paris, France., Lignereux F; Department of Ophthalmology Santé Atlantique, Nantes Polyclinic, Nantes, France., Rozot P; Department of Ophthalmology, Juge Clinic, Marseille, France., Goguillot M; Stève Consultants, Oullins, France., Bugnard F; Stève Consultants, Oullins, France., Brézin AP; Department of Ophthalmology, Cochin Hospital, APHP, Paris, France. |
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| Jazyk: | angličtina |
| Zdroj: | Ophthalmology [Ophthalmology] 2023 May; Vol. 130 (5), pp. 478-487. Date of Electronic Publication: 2022 Dec 26. |
| DOI: | 10.1016/j.ophtha.2022.12.022 |
| Abstrakt: | Purpose: To estimate the incidence and assess the risk factors associated with 3 adverse events (AEs) after neodymium:yttrium-aluminum-garnet posterior capsulotomy (Nd:YAG-caps): ocular hypertension (OHT), macular edema (ME), and retinal detachment (RD). Design: Observational cohort study using a nationwide claims database. Participants: Adults who underwent Nd:YAG-caps between 2014 and 2017, with no ocular disease history in the year before. Methods: Patients who underwent Nd:YAG-caps were identified using data from the French national representative sample and followed up for 12 months postprocedure. The time to AE was assessed using the Kaplan-Meier method. Factors associated with AE were assessed using Cox models. Main Outcome Measures: Neodymium:YAG-caps epidemiology, patients' characteristics, proportion of patients with AE, and hazard ratios (HRs) associated with variables identified as factors associated with AEs. Results: During the study period, 6210 patients received Nd:YAG-caps (7958 procedures). The mean age (± standard deviation) at Nd:YAG-caps was 75.0 (± 10.3) years. The 3-month and 12-month overall AE rates (≥ 1 AE of interest) were 8.6% and 13.3%, respectively. Among patients with ≥ 1 AE of interest, 68.4% of AEs occurred within 3 months post-Nd:YAG-caps. Three-month rates were ≈5% for OHT and ME. Retinal detachment remained ≤ 0.5% over follow-up. Cox models showed that patients with Nd:YAG-caps performed within 1 year after cataract surgery had a higher risk of AEs than those with later Nd:YAG-caps (hazard ratio [HR], 1.314 [1.034-1.669], P = 0.0256), notably ME (HR, 1.500 [1.087-2.070], P = 0.0137). Diabetic patients were more at risk of OHT (HR, 1.233 [1.005-1.513], P = 0.0448) and ME (HR, 1.810 [1.446-2.266], P < 0.0001) than nondiabetic patients. Patients with Nd:YAG-caps performed between 1 and 2 years after cataract surgery were more at risk of OHT than patients with later Nd:YAG-caps (HR, 1.429 [1.185-1.723], P = 0.0002). Conclusions: According to a national claims database, OHT and ME were the most frequent AEs of interest post-Nd:YAG-caps, mainly observed within 3 months postprocedure, highlighting the need for a close follow-up during this period or a delayed capsulotomy. Diabetes and an early Nd:YAG-caps after cataract surgery were among the main drivers for AE occurrence. Financial Disclosure(s): Proprietary or commercial disclosure may be found after the references. (Copyright © 2022 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.) |
| Databáze: | MEDLINE |
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