| Popis: |
To estimate the incidence and assess the risk factors associated with 3 adverse events (AE) of interest after Nd:YAG posterior capsulotomy (Nd:YAG-caps): ocular hypertension (OHT), macular edema (ME) and retinal detachment (RD).Observational cohort study using a nationwide claims database.Adults who underwent Nd:YAG-caps between 2014 and 2017, with no ocular disease history in the year before.Nd:YAG-caps patients were identified using data from the French national 1/97Nd:YAG-caps epidemiology; patients' characteristics; proportion of patients with AE; Hazard ratios (HRs) associated to variables identified as factors associated with AEs of interest, overall and by AE.During the study period, 6,210 patients with Nd:YAG-caps were identified (7,958 procedures). The mean age (±sd) at Nd:YAG-caps was 75.0 (±10.3) years. The 3-month and 12-month overall AE rates (≥1 AE of interest [OHT, ME, RD]) 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 similar for OHT and ME (≈5%). RD rate remained ≤0.5% over the entire follow-up. Cox models showed that patients with Nd:YAG-caps performed within 1-year post-cataract surgery were of higher risk of AE than those with later Nd:YAG-caps (HR 1.314 [1.034-1.669], p=0.0256). 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=.0001) than non-diabetic ones. Patients with Nd:YAG-caps within 1-year post-cataract surgery were more at risk of ME (HR 1.500 [1.087-2.070], p=0.0137). Patients with Nd:YAG-caps performed between the first- and second-year post-cataract were more at risk of OHT than patients with later Nd:YAG-caps (HR 1.429 [1.185-1.723], p=0.0002).Based on a national claims database, OHT and ME were the most frequent AE of interest post-Nd:YAG-caps, mainly observed within the first 3 months post-procedure, highlighting the need for a close follow-up during this period or a delayed capsulotomy if possible. Diabetes and an early Nd:YAG-caps post-cataract surgery were among the main drivers for AE occurrence. |
