ESCRS - PP04.07 - Posterior Capsule Opacification: Analysing 130,000 Cataract Surgeries With Natural Language Processing Ai To Determine Incidence And Risk Factors

Posterior Capsule Opacification: Analysing 130,000 Cataract Surgeries With Natural Language Processing Ai To Determine Incidence And Risk Factors

Published 2024 - 42nd Congress of the ESCRS

Reference: PP04.07 | Type: Poster | DOI: 10.82333/vbaq-sd63

Authors: Ken Kawamoto* 1 , Joshua Luis 2 , Quang Nguyen 3 , Laxmi Raja 1 , Alex Ionides 1

1Moorfields Eye Hospital NHS Foundation Trust,London,United Kingdom, 2Moorfields Eye Hospital NHS Foundation Trust,London,United Kingdom;UCL Institute of Ophthalmology,London,United Kingdom, 3UCL Institute of Ophthalmology,London,United Kingdom

Purpose

Primary – to ascertain the rate of YAG capsulotomy for posterior capsule opacification following phacoemulsification and IOL insertion. Secondary – to determine possible risk factors which affect the likelihood of requiring YAG capsulotomy.

Setting

Moorfields Eye Hospital NHS Foundation Trust. Large tertiary centre in London, UK covering 11 surgical sites.

Methods

All surgeries were carried out between 1st Sept 2012 to 31st Dec 2020. Data was extracted from electronic patient records: patient demographics, laterality, concurrent surgical procedure (corneal, vitreoretinal, glaucoma), intraoperative complications, type of intraocular lens, location of IOL placement, surgeon grade. Exclusion criteria were IOL types used in fewer than 100 cases and surgical capsulotomy performed at the time of surgery. Natural Language Processing was conducted using a state-of-the-art generative large language model, Mixtral-8x7B. One-shot inference was applied to clinical letters to determine whether patients had undergone YAG capsulotomy procedures in the operated eye.

Results

139668 eyes from 91944 patients were included. The overall YAG capsulotomy rate was 3.8%. The Alcon MTA (n=145, p=0.018), SA60AT (n=2673, p<0.001), SN6A (n=6470, p<0.001), MA60AC (n=4504, p=0.002), and MA60MA (n=1120, p<0.001) lenses were associated with higher, and Zeiss CT Lucia lens (n=1013, p=0.009) with lower YAG capsulotomy rate when compared to the SN60WF lens (n=123297) with statistical significance. Age was inversely correlated to YAG capsulotomy rate at 2.0% (1.7-2.2%) per year. Asian, Black and mixed ethnicities were associated with lower YAG capsulotomy rates compared to White ethnicity (P<0.001). Concurrent corneal surgery was associated with higher YAG capsulotomy rates (p<0.001).

Conclusions

This large longitudinal dataset representing a diverse population from London, UK shows an overall rate of PCO requiring YAG capsulotomy of 3.8%. A range of patient and surgical factors appear to affect the rate of YAG capsulotomy, including the choice of IOL, age, ethnicity and concurrent corneal surgery.