Risk factors for posterior capsule opacification following phacovitrectomy: a six-year retrospective analysis

Abstract Purpose To study risk factors for Nd:YAG capsulotomy (YAG-CT) due to visually disturbing posterior capsule opacification (PCO) after combined cataract surgery and vitrectomy, phaco-vitrectomy (PhV). Methods Single-center retrospective comparative cohort study. We included 196 patients (197 eyes) undergoing PhV. Electronic medical records provided baseline patient data, data on indication for vitrectomy, surgery data including intra-ocular lens (IOL) type, complications, and YAG-CT incidence during 6-year follow-up after PhV. Univariate and multivariate regression analyses assessed associations of various factors with YAG-CT incidence. Results Fifty-four eyes (27.41%) underwent YAG-CT during the follow-up period. One of the three hydrophilic acrylic IOLs showed the lowest YAG-CT incidence. Adjusted Odds Ratios (aORs) for YAG-CT were significantly higher for the hydrophobic acrylic IOL (aOR = 5.85, p < .05), and the two other hydrophilic acrylic IOLs (aOR = 29.0, p < 0.001 and aOR = 79.4, p < 0.001). Compared with PhV for macular hole, PhV for epiretinal membranes (aOR = 9.9, p < 0.01), retinal detachment (aOR = 25.4, p < 0.01), and silicon oil removal (aOR = 22.4, p < 0.05) correlated with higher YAG-CT incidence. Type 2 diabetes correlated with increased YAG-CT incidence (aOR = 6.7, p < 0.01). Conclusion IOL type is a key factor in development of visually disturbing PCO after phacovitrectomy. One hydrophilic acrylic IOL outperformed other examined IOLs in reducing YAG-CT incidence after PhV. Retinal disease, as well as type 2 diabetes, correlated with YAG-CT, and should motivate a choice of an IOL type associated with a low YAG-CT incidence for PhV.