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  • Adverse Events After Nd:YAG Capsulotomy

    By Jean Shaw
    Selected by Russell N. Van Gelder, MD, PhD
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    Journal Highlights

    Ophthalmology, May 2023

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    Dot et al. estimated the incidence of and risk factors for three adverse events (AEs) within 12 months after Nd:YAG capsulotomy (Nd:YAG-caps). Of the three AEs of interest—ocu­lar hypertension (OHT), macular edema (ME), and retinal detach­ments (RDs)—they found that OHT and ME were most likely to occur. They also found that patients who had diabetes and under­went Nd:YAG-caps between one and two years after their cataract surgery were more likely to experience an AE.

    For this observational cohort study, known as the French YAG 2 Study, the researchers used a national claims database to identify patients who had Nd:YAG-caps between 2014 and 2017. The rates of all AEs, including OHT/ glaucoma and ME, were assessed quar­terly during 12 months of follow-up, with follow-up extended to 18 months for RDs.

    All told, 6,210 patients were includ­ed in the study population, represent­ing 7,958 procedures. Nearly two-thirds (65.3%) were women, and the mean age was 75 ± 10.3 years. The Nd:YAG-caps procedures were categorized as very early (within one year of cataract surgery; 8.7% of participants), early (between the first and second years after cataract surgery; 23.3%), and late (two or more years after cataract surgery; 68%).

    Three-month and 12-month rates for the AEs of interest were 8.6% and 13.3%, respectively. At the 12-month mark, OHT/glaucoma was the most frequent AE, with a rate of 9.6%. In comparison, the rate for ME was 6.4% during the same time period. RDs were rare, occurring at a rate of less than 1% at any time during follow-up.

    Diabetes emerged as a contributing factor, with affected patients at greater risk of OHT (hazard ratio [HR], 1.233; p = .0448) and ME (HR, 1.810; p < .0001) than those without diabetes. Early Nd: YAG-caps also emerged as a risk factor, with those who underwent the pro­cedure within one to two years after cataract surgery more likely to develop OHT than those who had it later on (HR, 1.429; p = .0002).

    The original article can be found here.