Posterior Capsule Opacification (Pco) Following Phacovitrectomy - Risk Factors Analysis
Published 2024 - 42nd Congress of the ESCRS
Reference: PP04.11 | Type: Poster | DOI: 10.82333/jvnk-p417
Authors: Mieszko Lachota* 1 , Agata Frajdenberg 2 , Karolina Radl Steiner 2 , Wojciech Hautz 1 , Bjorn Johansson 2 , Marcin Czajka 2
1Department of Ophthalmology,Children’s Memorial Health Institute,Warsaw,Poland, 2Department of Ophthalmology and Department of Clinical and Experimental Medicine,Linkoping University,Linkoping,Sweden
Purpose
Posterior capsule opacification (PCO) is the most common complication after both cataract surgery and phacovitrectomy. Treatment for clinically significant PCO typically involves a YAG capsulotomy (YAG-CT), which, despite its relative simplicity, is not free of complications and places a burden on financially constrained health care. Limited knowledge on post-phacovitrectomy PCO risk factors as well as recent surgical advances in the field urged for a comprehensive evaluation of post-phacovitrectomy PCO. Hence, we set out to identify risk factors contributing to posterior capsule opacification requiring YAG-CT after combined microincision cataract surgery (MICS) and small-gauge vitrectomy.
Setting
197 consecutive phacovitrectomy surgeries (196 patients) performed at the Department of Ophthalmology, Linköping University Hospital (Linköping, Sweden) were reviewed.
Methods
A retrospective single-center cohort study of 196 patients (197 eyes) who underwent phacovitrectomy with hydrophobic or hydrophilic acrylic intraocular lens (IOL) implantation, with a 6-year follow-up. Both simple and multiple regression analyses assessed the association of various factors with PCO formation.
Results
PCO requiring YAG-CT developed in 54 eyes (27.41%). The MJ14 hydrophilic acrylic IOL demonstrated the lowest PCO risk compared to hydrophobic PCB00 (aOR = 5.85, p < .05), hydrophilic MI60 (aOR = 29, p <.001), and Asphina 409M (aOR = 79.39, p <.001) IOLs. Relative to macular holes, other indications for vitrectomy such as epiretinal membranes (aOR = 9.91, p <.01), rhegmatogenous retinal detachment (aOR = 25.44, p <.01), or removing silicon oil after previous vitrectomy (aOR = 22.44 (p < .05) carried increased PCO risk. Type 2 diabetes also increased PCO risk with aOR = 6.72 (p < .01).
Conclusions
IOL type is a key factor in PCO development after phacovitrectomy. MJ14, a modified hydrophilic acrylic IOL, was superior to all other tested IOLs in reducing the incidence of PCO after phacovitrectomy in a long-term follow-up. Additionally, the underlying retinal disease, as well as type 2 diabetes, have a considerable impact on PCO risk. Clinicians should be aware of these factors, as they warrant more frequent follow-ups and a careful IOL choice.