ESCRS - FP13.07 - Incidence Of Retinal Detachment, Macular Edema And Ocular Hypertension Following Nd:Yag Capsulotomy: A Population-Based Nation-Wide Study – The Freyag2 Study

Incidence Of Retinal Detachment, Macular Edema And Ocular Hypertension Following Nd:Yag Capsulotomy: A Population-Based Nation-Wide Study – The Freyag2 Study

Published 2023 - 41st Congress of the ESCRS

Reference: FP13.07 | Type: Free paper | DOI: 10.82333/bc0d-2560

Authors: Corinne Dot* 1 , Cédric Schweitzer 2 , Antoine Labbe 3 , Pascal Rozot 4 , Francois Lignereux 5 , Antoine Brezin 6

1CHU E.Herriot,Lyon,France;Val De Grâce,Paris,France, 2CHU Bordeaux,Bordeaux,France, 3XV-XX,Paris,France, 4Juge clinic,Marseille,France, 5atlantic clinic,Nantes,France, 6CHU Cochin,Paris,France

Purpose

To estimate the incidence and assess the risk factors associated with 3 adverse events (AE) of interest observed post-Nd:YAG posterior capsulotomy (Nd:YAG-caps): ocular hypertension (OHT), macular edema (ME) and retinal detachment (RD).

Setting

Observational cohort study based on a nationwide claims database.

Methods

Adults who underwent Nd:YAG-caps between 2014 and 2017, with no history of ocular disease in the year before Nd:YAG-caps were included.

Nd:YAG-caps patients were identified based on claims data from the French national 1/97th representative sample and followed-up 12 months post-Nd:YAG-caps. The time to AE was assessed using Kaplan-Meier method. Factors associated with AE were assessed using Cox models.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.

 

Results

 The 3-month overall AE rate (≥1 AE of interest [OHT, ME, RD]) was 8.6% and reached 13.3% at one year. Among patients with ≥1 AE of interest, 68.4% of AEs were first reported within 3 months post-Nd:YAG-caps. Three-month rates were similar for OHT and ME (≈5%). 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 procedures done later (HR 1.314 [1.034-1.669]). Diabetic patients were more at risk of OHT and ME than non-diabetic ones (HR 1.233 [1.005-1.513] and 1.810 [1.446-2.266], respectively). Patients with Nd:YAG-caps within 1-year post-cataract surgery were more at risk of ME (HR 1.500 [1.087-2.070]). 

 

 

Conclusions

Based on a real-world 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 a Nd:YAG-caps done soon after cataract surgery were among the main drivers for AE occurrence.