Adverse clinical consequences of neodymium:YAG laser treatment of posterior capsule opacification.
OBJECTIVE
To evaluate the clinical consequences of complications from neodymium:YAG (Nd:YAG) laser capsulotomy for posterior capsule opacification (PCO) over the lives of cataract patients.


METHODS
CHU de Caen, Caen, France.


METHODS
A model was constructed to estimate the lifetime clinical consequences of postoperative PCO treated by Nd:YAG laser capsulotomy. The probability of death was modeled from French mortality tables as a polynomial function of sex and age. The probability of becoming blind was modeled as a function of age from data in the literature. The incidence of Nd:YAG complications came from the literature. The rate of Nd:YAG capsulotomy over time was modeled as a survival curve using data from a cohort of 3335 patients.


RESULTS
Over 9 years in a 70-year-old population, switching from an IOL with a 20% Nd:YAG capsulotomy rate at 3 years to an IOL with a 5% rate would avoid 1 chronic intraocular pressure increase requiring medical follow-up in every 54 surgeries, 1 case of glaucoma in every 237 surgeries, 1 case of cystoid macular edema in every 265 surgeries, and 1 retinal detachment in every 265 surgeries. A 3-year clinical study would only capture one-third to one-half of long-term adverse events of Nd:YAG capsulotomy.


CONCLUSIONS
Reducing PCO and the associated use Nd:YAG laser capsulotomy may contribute to preserving visual acuity in patients over their lifetimes.
CHU de Caen, Caen, France. billotte-c@chu-caen.fr
Christian
C
Billotte
Gilles
G
Berdeaux
D000368:Aged; D002386:Cataract / Q000628:therapy*; D005260:Female; D006801:Humans; D015994:Incidence; D053685:Laser Therapy / Q000009:adverse effects*; D007903:Lens Capsule, Crystalline / Q000601:surgery*; D007910:Lenses, Intraocular; D008297:Male; D008390:Markov Chains; D008954:Models, Biological; D011183:Postoperative Complications; D015996:Survival Rate