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.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6189124PMC
http://dx.doi.org/10.1038/s41433-018-0131-2DOI Listing

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Article Synopsis
  • - Lacteocrumenasia is a rare complication that can occur after cataract surgery, classified as a late-onset capsular block syndrome (CBS) and often associated with myopia, though its exact cause remains unclear.
  • - A case study of a 62-year-old male revealed that after treatment with Nd-YAG laser to address CBS, there was an improvement in vision (over 1.0 diopters), despite minimal changes in the depth of the intraocular lens as measured by AS-OCT.
  • - The findings suggest that, unlike early-onset CBS where myopia is linked to the lens' positioning, late-onset CBS may not involve abnormal lens positioning, as indicated by the stable lens depth in this case
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Comment on the evaluation of the effect of Nd-YAG capsulotomy on posterior ocular vascular structures by Optical coherence tomography angiography.

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June 2023

Department of Ophthalmology, Institute of Medical Sciences & SUM Hospital, Siksha O Anusandhan (deemed to be) University, 8-Kalinga Nagar, Bhubaneswar 751003, India. Electronic address:

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Background: We aimed to examine the changes in retinal, choroidal and optic nerve head vascular structures after Nd-YAG laser application due to posterior capsule opacification after cataract surgery by Optical coherence tomography angiography (OCTA).

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