Posterior capsular opacification and YAG laser capsulotomy in uveitis patients following cataract surgery.

Autor: Levy-Clarke GA; Department of Ophthalmology, West Virginia University Eye Institute, Morgantown, WV; Laboratory of Immunology, National Eye Institute, National Institutes of Health, Bethesda, MD., Newcomb CW; Center for Clinical Epidemiology and Biostatistics, Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA., Ying GS; Department of Ophthalmology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA., Groth SL; Vanderbilt Eye Institute, Vanderbilt University Medical Center, Nashville, TN., Kothari S; Division of Child Care Services, New York State Office of Children and Family Services, Westchester Regional Office, Valhalla, NY., Payal A; Department of Ophthalmology, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD., Begum H; Department of Ophthalmology, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD., Liesegang TL; Department of Ophthalmology, Oregon Health and Science University, Portland, OR., Foster CS; Department of Ophthalmology, Harvard Medical School, Boston, MA; Massachusetts Eye Research and Surgery Institution, Waltham, MA., Jabs DA; Department of Ophthalmology, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD; Center for Clinical Trials and Evidence Synthesis, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD., Nussenblatt R; Laboratory of Immunology, National Eye Institute, National Institutes of Health, Bethesda, MD., Rosenbaum JT; Department of Ophthalmology, Oregon Health and Science University, Portland, OR; Department of Public Health and Preventive Medicine, Oregon Heath and Science University, Portland, OR; Legacy Devers Eye Institute, Portland, OR., Sen HN; Laboratory of Immunology, National Eye Institute, National Institutes of Health, Bethesda, MD., Suhler EB; Department of Ophthalmology, Oregon Health and Science University, Portland, OR; Portland Veteran's Affairs Medical Center, Portland, OR., Thorne JE; Department of Ophthalmology, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD; Center for Clinical Trials and Evidence Synthesis, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD., Bhatt NP; Department of Ophthalmology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA., Dreger KA; Department of Ophthalmology, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD; Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD., Buchanich JM; Center for Occupational Biostatistics and Epidemiology, University of Pittsburgh School of Public Health, Pittsburgh, PA., Kempen JH; Department of Ophthalmology, Harvard Medical School, Boston, MA; Sight for Souls, Fort Myers, FL; Departments of Global Health and Social Medicine, Harvard Medical School, Boston, MA; MCM Eye Unit, MyungSung Christian Medical Center (MCM) General Hospital and MyungSung Medical School, Addis Ababa, Ethiopia; Department of Ophthalmology, Addis Ababa University School of Medicine, Addis Ababa, Ethiopia., Gangaputra S; Vanderbilt Eye Institute, Vanderbilt University Medical Center, Nashville, TN. Electronic address: sapna.gangaputra@vumc.org.
Jazyk: angličtina
Zdroj: Canadian journal of ophthalmology. Journal canadien d'ophtalmologie [Can J Ophthalmol] 2024 May 27. Date of Electronic Publication: 2024 May 27.
DOI: 10.1016/j.jcjo.2024.05.004
Abstrakt: Objective: To evaluate the incidence of visually significant posterior capsule opacification (PCO with visual acuity ≤20/50) and the incidence of Nd:YAG laser capsulotomy in the year following cataract surgery for uveitic eyes.
Method: Patients were identified from the Systemic Immunosuppressive Therapy for Eye Diseases (SITE) Cohort Study using a standardized chart review process.
Results: Among 1,855 uveitic eyes of 1,370 patients who had undergone cataract surgery, visually significant PCO occurred in 297 eyes (16%), and YAG laser capsulotomy was done in 407 eyes (22%) within the first year following surgery. Higher odds of developing 20/50 visual acuity attributed to PCO were noted in children and young adults compared with adults older than 65 years of age (overall p = 0.03). Poorer preoperative visual acuity (overall p = 0.0069) and postoperative inflammation (odds ratio [OR] = 1.83; 95% CI, 1.37-2.45; p < 0.0001) were associated with PCO incidence. In multivariable analysis, risk factors for YAG laser capsulotomy were younger age groups compared with those older than 65 years of age at the time of surgery (adjusted OR [aOR] = 1.90-2.24; 95% CI, 1.90-2.24; overall p = 0.0007), female sex (aOR = 1.37; 95% CI, 1.03-1.82; p = 0.03), postoperative active inflammation (aOR = 165; 95% CI, 1.27-2.16; overall p < 0.0001), extracapsular cataract extraction compared with phacoemulsification (aOR = 1.70; 95% CI, 1.17-2.47; overall p < 0.0001), and insertion of an intraocular lens (aOR = 4.60; 95% CI, -2.29-9.25; p < 0.0001). Black race was associated with lower YAG laser capsulotomy incidence than Whites (aOR = 0.36; 95% CI, 0.24-0.52; overall p < 0.0001).
Conclusions: Vision-reducing (≤20/50) PCO is common, occurring in about one sixth of uveitic eyes within 1 year of cataract surgery; a higher number (22%) of eyes underwent YAG laser capsulotomy within the first year. Age and postoperative inflammation following cataract surgery are the variables most associated with the incidence of visually significant PCO and YAG laser capsulotomy.
(Copyright © 2024 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: