Cumulative probability and risk analysis for Nd:YAG laser capsulotomy

AIM: To estimate the cumulative probability of Nd:YAG capsulotomy at a teaching institution and evaluate secondary risk factors.METHODS: The records of all patients who underwent phacoemulsification with intraocular lens(IOL) placement between 2005-2010 were retrospectively reviewed. The cumulative probability of Nd:YAG capsulotomy(capsulotomy) was calculated using KaplanMeier survival analysis and secondary risk factors were evaluated using the Cox proportional hazards regression model. RESULTS: One thousand three hundred and fifty four charts were reviewed. A total of 70 capsulotomies wereperformed. The mean follow-up was 19.4 mo(standard deviation 17 mo). The cumulative probability of capsulotomy was 4% at 1 year, 5% at 2 year, and 9% at 3 year. Multivariate analysis demonstrated an increased risk with younger age(HR = 1.03, CI 1.01-1.05, P = 0.007), placement of sulcus IOL(HR = 2.57, CI 1.32-4.99, P = 0.005), ocular trauma(HR = 2.34, CI 1.13-4.83, P = 0.02), and phacoemulsification by a more experienced surgeon(HR = 4.32, CI 1.89-9.87, P = 0.001).CONCLUSION: Cumulative probability of capsulotomy was lower than previously reported. Posterior capsule opacification was strongly associated with younger age and factors associated with high-risk cataract surgery. Surgeon awareness to the risk factors that correlate with posterior capsulotomy may allow for more thorough pre-operative disclosure and enhance patient satisfaction.