Incidence and risk factors of Nd:YAG capsulotomy after phacoemulsification in non‐diabetic and diabetic patients
Identifieur interne : 000C40 ( Istex/Corpus ); précédent : 000C39; suivant : 000C41Incidence and risk factors of Nd:YAG capsulotomy after phacoemulsification in non‐diabetic and diabetic patients
Auteurs : Mostafa A. Elgohary ; Jonathan G. DowlerSource :
- Clinical & Experimental Ophthalmology [ 1442-6404 ] ; 2006-08.
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Abstract
Purpose: To estimate the cumulative incidence and identify the risk factors of posterior capsule opacification (PCO) that required Nd:YAG capsulotomy in non‐diabetic and diabetic patients. Methods: Retrospective case‐note review of 806 consecutive patients that underwent phacoemulsification and intraocular lens (IOL) implantation, 327 (40.6%) of whom were diabetic. Results: The cumulative incidence of Nd:YAG capsulotomy were 10.6%, 14.8%, 21.2% and 28.6% in non‐diabetic patients; and 9%, 9.4%, 15.3% and 5.3% in diabetic patients after 1, 2, 3 and 4 years, respectively. A multivariate Cox regression analysis showed that, over the follow‐up period, diabetes mellitus was associated with a decreased risk of Nd:YAG capsulotomy (hazard ratio [HR] = 0.69; 95% confidence interval [CI] 0.47–0.99; P = 0.047), whereas age of 65 years or younger (HR = 1.58; 95% CI 1.09–2.27; P = 0.02), polymethylmethacrylate (PMMA) (HR = 3.98; 95% CI 1.60–9.95; P = 0.003) or plate‐haptic silicone IOLs (HR = 3.75; 95% CI 1.60–8.80; P = 0.002) in comparison with three‐piece silicone IOLs, postoperative inflammation (HR = 2.62; 95% CI 1.56–4.42; P < 0.001) and pars plana vitrectomy (HR = 1.85; 95% CI 1.20–2.83; P = 0.005) were associated with an increased risk. Subgroup analysis showed that in non‐diabetic patients, male gender (HR = 1.63; 95% CI 1.04–2.57; P = 0.03) was an additional risk factor and in diabetic patients there was no significant association between diabetes type, duration or retinopathy grade and the risk of Nd:YAG capsulotomy. Conclusion: Although diabetes mellitus appears to be associated with a lower long‐term incidence and a decreased risk of Nd:YAG capsulotomy, younger age, pars plana vitrectomy, postoperative inflammation, plate‐haptic silicone and PMMA IOLs in addition to male gender in non‐diabetic patients appear to be associated with a greater risk. Estimation of the incidence and risk factors of PCO should help in patient counselling and to design methods to reduce or prevent its development.
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DOI: 10.1111/j.1442-9071.2006.01263.x
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<record><TEI wicri:istexFullTextTei="biblStruct"><teiHeader><fileDesc><titleStmt><title xml:lang="en">Incidence and risk factors of Nd:YAG capsulotomy after phacoemulsification in non‐diabetic and diabetic patients</title><author><name sortKey="Elgohary, Mostafa A" sort="Elgohary, Mostafa A" uniqKey="Elgohary M" first="Mostafa A" last="Elgohary">Mostafa A. Elgohary</name><affiliation><mods:affiliation>Medical Retina Service, Moorfields Eye Hospital, London, UK; and</mods:affiliation></affiliation><affiliation><mods:affiliation>Tanta Ophthalmology University Hospital, Tanta, Egypt</mods:affiliation></affiliation></author><author><name sortKey="Dowler, Jonathan G" sort="Dowler, Jonathan G" uniqKey="Dowler J" first="Jonathan G" last="Dowler">Jonathan G. Dowler</name><affiliation><mods:affiliation>Medical Retina Service, Moorfields Eye Hospital, London, UK; and</mods:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:F6C4228C5A4E572E0AB6ECF415384BFDFE4473FE</idno><date when="2006" year="2006">2006</date><idno type="doi">10.1111/j.1442-9071.2006.01263.x</idno><idno type="url">https://api.istex.fr/document/F6C4228C5A4E572E0AB6ECF415384BFDFE4473FE/fulltext/pdf</idno><idno type="wicri:Area/Istex/Corpus">000C40</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a" type="main" xml:lang="en">Incidence and risk factors of Nd:YAG capsulotomy after phacoemulsification in non‐diabetic and diabetic patients</title><author><name sortKey="Elgohary, Mostafa A" sort="Elgohary, Mostafa A" uniqKey="Elgohary M" first="Mostafa A" last="Elgohary">Mostafa A. Elgohary</name><affiliation><mods:affiliation>Medical Retina Service, Moorfields Eye Hospital, London, UK; and</mods:affiliation></affiliation><affiliation><mods:affiliation>Tanta Ophthalmology University Hospital, Tanta, Egypt</mods:affiliation></affiliation></author><author><name sortKey="Dowler, Jonathan G" sort="Dowler, Jonathan G" uniqKey="Dowler J" first="Jonathan G" last="Dowler">Jonathan G. Dowler</name><affiliation><mods:affiliation>Medical Retina Service, Moorfields Eye Hospital, London, UK; and</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">Clinical & Experimental Ophthalmology</title><idno type="ISSN">1442-6404</idno><idno type="eISSN">1442-9071</idno><imprint><publisher>Blackwell Publishing Asia</publisher><pubPlace>Melbourne, Australia</pubPlace><date type="published" when="2006-08">2006-08</date><biblScope unit="volume">34</biblScope><biblScope unit="issue">6</biblScope><biblScope unit="page" from="526">526</biblScope><biblScope unit="page" to="534">534</biblScope></imprint><idno type="ISSN">1442-6404</idno></series><idno type="istex">F6C4228C5A4E572E0AB6ECF415384BFDFE4473FE</idno><idno type="DOI">10.1111/j.1442-9071.2006.01263.x</idno><idno type="ArticleID">CEO1263</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">1442-6404</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Nd:YAG</term><term>capsulotomy</term><term>cataract</term><term>diabetes mellitus</term><term>incidence</term><term>intraocular</term><term>lens</term><term>phacoemulsification</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Purpose: To estimate the cumulative incidence and identify the risk factors of posterior capsule opacification (PCO) that required Nd:YAG capsulotomy in non‐diabetic and diabetic patients. Methods: Retrospective case‐note review of 806 consecutive patients that underwent phacoemulsification and intraocular lens (IOL) implantation, 327 (40.6%) of whom were diabetic. Results: The cumulative incidence of Nd:YAG capsulotomy were 10.6%, 14.8%, 21.2% and 28.6% in non‐diabetic patients; and 9%, 9.4%, 15.3% and 5.3% in diabetic patients after 1, 2, 3 and 4 years, respectively. A multivariate Cox regression analysis showed that, over the follow‐up period, diabetes mellitus was associated with a decreased risk of Nd:YAG capsulotomy (hazard ratio [HR] = 0.69; 95% confidence interval [CI] 0.47–0.99; P = 0.047), whereas age of 65 years or younger (HR = 1.58; 95% CI 1.09–2.27; P = 0.02), polymethylmethacrylate (PMMA) (HR = 3.98; 95% CI 1.60–9.95; P = 0.003) or plate‐haptic silicone IOLs (HR = 3.75; 95% CI 1.60–8.80; P = 0.002) in comparison with three‐piece silicone IOLs, postoperative inflammation (HR = 2.62; 95% CI 1.56–4.42; P < 0.001) and pars plana vitrectomy (HR = 1.85; 95% CI 1.20–2.83; P = 0.005) were associated with an increased risk. Subgroup analysis showed that in non‐diabetic patients, male gender (HR = 1.63; 95% CI 1.04–2.57; P = 0.03) was an additional risk factor and in diabetic patients there was no significant association between diabetes type, duration or retinopathy grade and the risk of Nd:YAG capsulotomy. Conclusion: Although diabetes mellitus appears to be associated with a lower long‐term incidence and a decreased risk of Nd:YAG capsulotomy, younger age, pars plana vitrectomy, postoperative inflammation, plate‐haptic silicone and PMMA IOLs in addition to male gender in non‐diabetic patients appear to be associated with a greater risk. Estimation of the incidence and risk factors of PCO should help in patient counselling and to design methods to reduce or prevent its development.</div></front></TEI><istex><corpusName>wiley</corpusName><author><json:item><name>Mostafa A Elgohary MRCOphth</name><affiliations><json:string>Medical Retina Service, Moorfields Eye Hospital, London, UK; and</json:string><json:string>Tanta Ophthalmology University Hospital, Tanta, Egypt</json:string></affiliations></json:item><json:item><name>Jonathan G Dowler MRCOphth</name><affiliations><json:string>Medical Retina Service, Moorfields Eye Hospital, London, UK; and</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>capsulotomy</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>cataract</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>diabetes mellitus</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>incidence</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>intraocular</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>lens</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>Nd:YAG</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>phacoemulsification</value></json:item></subject><articleId><json:string>CEO1263</json:string></articleId><language><json:string>eng</json:string></language><abstract>Purpose: To estimate the cumulative incidence and identify the risk factors of posterior capsule opacification (PCO) that required Nd:YAG capsulotomy in non‐diabetic and diabetic patients. Methods: Retrospective case‐note review of 806 consecutive patients that underwent phacoemulsification and intraocular lens (IOL) implantation, 327 (40.6%) of whom were diabetic. Results: The cumulative incidence of Nd:YAG capsulotomy were 10.6%, 14.8%, 21.2% and 28.6% in non‐diabetic patients; and 9%, 9.4%, 15.3% and 5.3% in diabetic patients after 1, 2, 3 and 4 years, respectively. A multivariate Cox regression analysis showed that, over the follow‐up period, diabetes mellitus was associated with a decreased risk of Nd:YAG capsulotomy (hazard ratio [HR] = 0.69; 95% confidence interval [CI] 0.47–0.99; P = 0.047), whereas age of 65 years or younger (HR = 1.58; 95% CI 1.09–2.27; P = 0.02), polymethylmethacrylate (PMMA) (HR = 3.98; 95% CI 1.60–9.95; P = 0.003) or plate‐haptic silicone IOLs (HR = 3.75; 95% CI 1.60–8.80; P = 0.002) in comparison with three‐piece silicone IOLs, postoperative inflammation (HR = 2.62; 95% CI 1.56–4.42; P > 0.001) and pars plana vitrectomy (HR = 1.85; 95% CI 1.20–2.83; P = 0.005) were associated with an increased risk. Subgroup analysis showed that in non‐diabetic patients, male gender (HR = 1.63; 95% CI 1.04–2.57; P = 0.03) was an additional risk factor and in diabetic patients there was no significant association between diabetes type, duration or retinopathy grade and the risk of Nd:YAG capsulotomy. Conclusion: Although diabetes mellitus appears to be associated with a lower long‐term incidence and a decreased risk of Nd:YAG capsulotomy, younger age, pars plana vitrectomy, postoperative inflammation, plate‐haptic silicone and PMMA IOLs in addition to male gender in non‐diabetic patients appear to be associated with a greater risk. Estimation of the incidence and risk factors of PCO should help in patient counselling and to design methods to reduce or prevent its development.</abstract><qualityIndicators><score>8.43</score><pdfVersion>1.4</pdfVersion><pdfPageSize>595 x 780 pts</pdfPageSize><refBibsNative>true</refBibsNative><keywordCount>8</keywordCount><abstractCharCount>2027</abstractCharCount><pdfWordCount>4930</pdfWordCount><pdfCharCount>33089</pdfCharCount><pdfPageCount>9</pdfPageCount><abstractWordCount>278</abstractWordCount></qualityIndicators><title>Incidence and risk factors of Nd:YAG capsulotomy after phacoemulsification in non‐diabetic and diabetic patients</title><genre.original><json:string>article</json:string></genre.original><genre><json:string>article</json:string></genre><host><volume>34</volume><publisherId><json:string>CEO</json:string></publisherId><pages><total>9</total><last>534</last><first>526</first></pages><issn><json:string>1442-6404</json:string></issn><issue>6</issue><genre><json:string>journal</json:string></genre><language><json:string>unknown</json:string></language><eissn><json:string>1442-9071</json:string></eissn><title>Clinical & Experimental Ophthalmology</title><doi><json:string>10.1111/(ISSN)1442-9071</json:string></doi></host><publicationDate>2006</publicationDate><copyrightDate>2006</copyrightDate><doi><json:string>10.1111/j.1442-9071.2006.01263.x</json:string></doi><id>F6C4228C5A4E572E0AB6ECF415384BFDFE4473FE</id><score>1</score><fulltext><json:item><original>true</original><mimetype>application/pdf</mimetype><extension>pdf</extension><uri>https://api.istex.fr/document/F6C4228C5A4E572E0AB6ECF415384BFDFE4473FE/fulltext/pdf</uri></json:item><json:item><original>false</original><mimetype>application/zip</mimetype><extension>zip</extension><uri>https://api.istex.fr/document/F6C4228C5A4E572E0AB6ECF415384BFDFE4473FE/fulltext/zip</uri></json:item><istex:fulltextTEI uri="https://api.istex.fr/document/F6C4228C5A4E572E0AB6ECF415384BFDFE4473FE/fulltext/tei"><teiHeader><fileDesc><titleStmt><title level="a" type="main" xml:lang="en">Incidence and risk factors of Nd:YAG capsulotomy after phacoemulsification in non‐diabetic and diabetic patients</title></titleStmt><publicationStmt><authority>ISTEX</authority><publisher>Blackwell Publishing Asia</publisher><pubPlace>Melbourne, Australia</pubPlace><availability><p>WILEY</p></availability><date>2006</date></publicationStmt><sourceDesc><biblStruct type="inbook"><analytic><title level="a" type="main" xml:lang="en">Incidence and risk factors of Nd:YAG capsulotomy after phacoemulsification in non‐diabetic and diabetic patients</title><author><persName><forename type="first">Mostafa A</forename><surname>Elgohary</surname></persName><roleName type="degree">MRCOphth</roleName><note type="correspondence"><p>Correspondence: Dr Mostafa A Elgohary, Moorfields Eye Hospital, City Road, London EC1V 2PD, UK. Email:</p></note><affiliation>Medical Retina Service, Moorfields Eye Hospital, London, UK; and</affiliation><affiliation>Tanta Ophthalmology University Hospital, Tanta, Egypt</affiliation></author><author><persName><forename type="first">Jonathan G</forename><surname>Dowler</surname></persName><roleName type="degree">MRCOphth</roleName><affiliation>Medical Retina Service, Moorfields Eye Hospital, London, UK; and</affiliation></author></analytic><monogr><title level="j">Clinical & Experimental Ophthalmology</title><idno type="pISSN">1442-6404</idno><idno type="eISSN">1442-9071</idno><idno type="DOI">10.1111/(ISSN)1442-9071</idno><imprint><publisher>Blackwell Publishing Asia</publisher><pubPlace>Melbourne, Australia</pubPlace><date type="published" when="2006-08"></date><biblScope unit="volume">34</biblScope><biblScope unit="issue">6</biblScope><biblScope unit="page" from="526">526</biblScope><biblScope unit="page" to="534">534</biblScope></imprint></monogr><idno type="istex">F6C4228C5A4E572E0AB6ECF415384BFDFE4473FE</idno><idno type="DOI">10.1111/j.1442-9071.2006.01263.x</idno><idno type="ArticleID">CEO1263</idno></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>2006</date></creation><langUsage><language ident="en">en</language></langUsage><abstract xml:lang="en"><p>Purpose: To estimate the cumulative incidence and identify the risk factors of posterior capsule opacification (PCO) that required Nd:YAG capsulotomy in non‐diabetic and diabetic patients. Methods: Retrospective case‐note review of 806 consecutive patients that underwent phacoemulsification and intraocular lens (IOL) implantation, 327 (40.6%) of whom were diabetic. Results: The cumulative incidence of Nd:YAG capsulotomy were 10.6%, 14.8%, 21.2% and 28.6% in non‐diabetic patients; and 9%, 9.4%, 15.3% and 5.3% in diabetic patients after 1, 2, 3 and 4 years, respectively. A multivariate Cox regression analysis showed that, over the follow‐up period, diabetes mellitus was associated with a decreased risk of Nd:YAG capsulotomy (hazard ratio [HR] = 0.69; 95% confidence interval [CI] 0.47–0.99; P = 0.047), whereas age of 65 years or younger (HR = 1.58; 95% CI 1.09–2.27; P = 0.02), polymethylmethacrylate (PMMA) (HR = 3.98; 95% CI 1.60–9.95; P = 0.003) or plate‐haptic silicone IOLs (HR = 3.75; 95% CI 1.60–8.80; P = 0.002) in comparison with three‐piece silicone IOLs, postoperative inflammation (HR = 2.62; 95% CI 1.56–4.42; P < 0.001) and pars plana vitrectomy (HR = 1.85; 95% CI 1.20–2.83; P = 0.005) were associated with an increased risk. Subgroup analysis showed that in non‐diabetic patients, male gender (HR = 1.63; 95% CI 1.04–2.57; P = 0.03) was an additional risk factor and in diabetic patients there was no significant association between diabetes type, duration or retinopathy grade and the risk of Nd:YAG capsulotomy. Conclusion: Although diabetes mellitus appears to be associated with a lower long‐term incidence and a decreased risk of Nd:YAG capsulotomy, younger age, pars plana vitrectomy, postoperative inflammation, plate‐haptic silicone and PMMA IOLs in addition to male gender in non‐diabetic patients appear to be associated with a greater risk. Estimation of the incidence and risk factors of PCO should help in patient counselling and to design methods to reduce or prevent its development.</p></abstract><textClass xml:lang="en"><keywords scheme="keyword"><list><head>keywords</head><item><term>capsulotomy</term></item><item><term>cataract</term></item><item><term>diabetes mellitus</term></item><item><term>incidence</term></item><item><term>intraocular</term></item><item><term>lens</term></item><item><term>Nd:YAG</term></item><item><term>phacoemulsification</term></item></list></keywords></textClass></profileDesc><revisionDesc><change when="2006-08">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><original>false</original><mimetype>text/plain</mimetype><extension>txt</extension><uri>https://api.istex.fr/document/F6C4228C5A4E572E0AB6ECF415384BFDFE4473FE/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="Wiley, elements deleted: body"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="yes"</istex:xmlDeclaration><istex:document><component version="2.0" type="serialArticle" xml:lang="en"><header><publicationMeta level="product"><publisherInfo><publisherName>Blackwell Publishing Asia</publisherName><publisherLoc>Melbourne, Australia</publisherLoc></publisherInfo><doi origin="wiley" registered="yes">10.1111/(ISSN)1442-9071</doi><issn type="print">1442-6404</issn><issn type="electronic">1442-9071</issn><idGroup><id type="product" value="CEO"></id><id type="publisherDivision" value="ST"></id></idGroup><titleGroup><title type="main" sort="CLINICAL EXPERIMENTAL OPHTHALMOLOGY">Clinical & Experimental Ophthalmology</title></titleGroup></publicationMeta><publicationMeta level="part" position="08006"><doi origin="wiley">10.1111/ceo.2006.34.issue-6</doi><numberingGroup><numbering type="journalVolume" number="34">34</numbering><numbering type="journalIssue" number="6">6</numbering></numberingGroup><coverDate startDate="2006-08">August 2006</coverDate></publicationMeta><publicationMeta level="unit" type="article" position="6" status="forIssue"><doi origin="wiley">10.1111/j.1442-9071.2006.01263.x</doi><idGroup><id type="unit" value="CEO1263"></id></idGroup><countGroup><count type="pageTotal" number="9"></count></countGroup><titleGroup><title type="tocHeading1">Original Article</title><title type="tocHeading2">Clinical Science</title></titleGroup><eventGroup><event type="firstOnline" date="2006-07-12"></event><event type="publishedOnlineFinalForm" date="2006-07-12"></event><event type="xmlConverted" agent="Converter:BPG_TO_WML3G version:2.3.4 mode:FullText source:FullText result:FullText" date="2010-03-30"></event><event type="xmlConverted" agent="Converter:WILEY_ML3G_TO_WILEY_ML3GV2 version:3.8.8" date="2014-01-09"></event><event type="xmlConverted" agent="Converter:WML3G_To_WML3G version:4.1.7 mode:FullText,remove_FC" date="2014-10-16"></event></eventGroup><numberingGroup><numbering type="pageFirst" number="526">526</numbering><numbering type="pageLast" number="534">534</numbering></numberingGroup><correspondenceTo>Dr Mostafa A Elgohary, Moorfields Eye Hospital, City Road, London EC1V 2PD, UK. Email: <email>m.elgohary@doctors.org.uk</email></correspondenceTo><linkGroup><link type="toTypesetVersion" href="file:CEO.CEO1263.pdf"></link></linkGroup></publicationMeta><contentMeta><unparsedEditorialHistory>Received 8 March 2005; accepted 17 February 2006.</unparsedEditorialHistory><countGroup><count type="figureTotal" number="1"></count><count type="tableTotal" number="4"></count><count type="formulaTotal" number="0"></count><count type="referenceTotal" number="55"></count><count type="wordTotal" number="3923"></count><count type="linksPubMed" number="0"></count><count type="linksCrossRef" number="0"></count></countGroup><titleGroup><title type="main">Incidence and risk factors of Nd:YAG capsulotomy after phacoemulsification in non‐diabetic and diabetic patients</title><title type="shortAuthors">Elgohary and Dowler</title><title type="short">Capsulotomy in non‐diabetic and diabetic patients</title></titleGroup><creators><creator creatorRole="author" xml:id="cr1" affiliationRef="#a1 #a2" corresponding="yes"><personName><givenNames>Mostafa A</givenNames><familyName>Elgohary</familyName><degrees>MRCOphth</degrees></personName></creator><creator creatorRole="author" xml:id="cr2" affiliationRef="#a1"><personName><givenNames>Jonathan G</givenNames><familyName>Dowler</familyName><degrees>MRCOphth</degrees></personName></creator></creators><affiliationGroup><affiliation xml:id="a1" countryCode="GB"><unparsedAffiliation>Medical Retina Service, Moorfields Eye Hospital, London, UK; and</unparsedAffiliation></affiliation><affiliation xml:id="a2" countryCode="EG"><unparsedAffiliation>Tanta Ophthalmology University Hospital, Tanta, Egypt</unparsedAffiliation></affiliation></affiliationGroup><keywordGroup xml:lang="en"><keyword xml:id="k1">capsulotomy</keyword><keyword xml:id="k2">cataract</keyword><keyword xml:id="k3">diabetes mellitus</keyword><keyword xml:id="k4">incidence</keyword><keyword xml:id="k5">intraocular</keyword><keyword xml:id="k6">lens</keyword><keyword xml:id="k7">Nd:YAG</keyword><keyword xml:id="k8">phacoemulsification</keyword></keywordGroup><abstractGroup><abstract type="main" xml:lang="en"><title type="main">A<sc>bstract</sc></title><p><b>Purpose: </b> To estimate the cumulative incidence and identify the risk factors of posterior capsule opacification (PCO) that required Nd:YAG capsulotomy in non‐diabetic and diabetic patients.</p><p><b>Methods: </b> Retrospective case‐note review of 806 consecutive patients that underwent phacoemulsification and intraocular lens (IOL) implantation, 327 (40.6%) of whom were diabetic.</p><p><b>Results: </b> The cumulative incidence of Nd:YAG capsulotomy were 10.6%, 14.8%, 21.2% and 28.6% in non‐diabetic patients; and 9%, 9.4%, 15.3% and 5.3% in diabetic patients after 1, 2, 3 and 4 years, respectively. A multivariate Cox regression analysis showed that, over the follow‐up period, diabetes mellitus was associated with a decreased risk of Nd:YAG capsulotomy (hazard ratio [HR] = 0.69; 95% confidence interval [CI] 0.47–0.99; <i>P</i> = 0.047), whereas age of 65 years or younger (HR = 1.58; 95% CI 1.09–2.27; <i>P</i> = 0.02), polymethylmethacrylate (PMMA) (HR = 3.98; 95% CI 1.60–9.95; <i>P</i> = 0.003) or plate‐haptic silicone IOLs (HR = 3.75; 95% CI 1.60–8.80; <i>P</i> = 0.002) in comparison with three‐piece silicone IOLs, postoperative inflammation (HR = 2.62; 95% CI 1.56–4.42; <i>P</i> < 0.001) and pars plana vitrectomy (HR = 1.85; 95% CI 1.20–2.83; <i>P</i> = 0.005) were associated with an increased risk. Subgroup analysis showed that in non‐diabetic patients, male gender (HR = 1.63; 95% CI 1.04–2.57; <i>P</i> = 0.03) was an additional risk factor and in diabetic patients there was no significant association between diabetes type, duration or retinopathy grade and the risk of Nd:YAG capsulotomy.</p><p><b>Conclusion: </b> Although diabetes mellitus appears to be associated with a lower long‐term incidence and a decreased risk of Nd:YAG capsulotomy, younger age, pars plana vitrectomy, postoperative inflammation, plate‐haptic silicone and PMMA IOLs in addition to male gender in non‐diabetic patients appear to be associated with a greater risk. Estimation of the incidence and risk factors of PCO should help in patient counselling and to design methods to reduce or prevent its development.</p></abstract></abstractGroup></contentMeta><noteGroup><note xml:id="fn1" numbered="no"><p>Presentation: Poster at the International Congress of Ophthalmology (ICO), Sydney, Australia, 2002.</p></note></noteGroup></header></component></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Incidence and risk factors of Nd:YAG capsulotomy after phacoemulsification in non‐diabetic and diabetic patients</title></titleInfo><titleInfo type="abbreviated"><title>Capsulotomy in non‐diabetic and diabetic patients</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>Incidence and risk factors of Nd:YAG capsulotomy after phacoemulsification in non‐diabetic and diabetic patients</title></titleInfo><name type="personal"><namePart type="given">Mostafa A</namePart><namePart type="family">Elgohary</namePart><namePart type="termsOfAddress">MRCOphth</namePart><affiliation>Medical Retina Service, Moorfields Eye Hospital, London, UK; and</affiliation><affiliation>Tanta Ophthalmology University Hospital, Tanta, Egypt</affiliation><description>Correspondence: Dr Mostafa A Elgohary, Moorfields Eye Hospital, City Road, London EC1V 2PD, UK. Email: </description><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Jonathan G</namePart><namePart type="family">Dowler</namePart><namePart type="termsOfAddress">MRCOphth</namePart><affiliation>Medical Retina Service, Moorfields Eye Hospital, London, UK; and</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="article" displayLabel="article"></genre><originInfo><publisher>Blackwell Publishing Asia</publisher><place><placeTerm type="text">Melbourne, Australia</placeTerm></place><dateIssued encoding="w3cdtf">2006-08</dateIssued><edition>Received 8 March 2005; accepted 17 February 2006.</edition><copyrightDate encoding="w3cdtf">2006</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType><extent unit="figures">1</extent><extent unit="tables">4</extent><extent unit="references">55</extent><extent unit="words">3923</extent></physicalDescription><abstract lang="en">Purpose: To estimate the cumulative incidence and identify the risk factors of posterior capsule opacification (PCO) that required Nd:YAG capsulotomy in non‐diabetic and diabetic patients. Methods: Retrospective case‐note review of 806 consecutive patients that underwent phacoemulsification and intraocular lens (IOL) implantation, 327 (40.6%) of whom were diabetic. Results: The cumulative incidence of Nd:YAG capsulotomy were 10.6%, 14.8%, 21.2% and 28.6% in non‐diabetic patients; and 9%, 9.4%, 15.3% and 5.3% in diabetic patients after 1, 2, 3 and 4 years, respectively. A multivariate Cox regression analysis showed that, over the follow‐up period, diabetes mellitus was associated with a decreased risk of Nd:YAG capsulotomy (hazard ratio [HR] = 0.69; 95% confidence interval [CI] 0.47–0.99; P = 0.047), whereas age of 65 years or younger (HR = 1.58; 95% CI 1.09–2.27; P = 0.02), polymethylmethacrylate (PMMA) (HR = 3.98; 95% CI 1.60–9.95; P = 0.003) or plate‐haptic silicone IOLs (HR = 3.75; 95% CI 1.60–8.80; P = 0.002) in comparison with three‐piece silicone IOLs, postoperative inflammation (HR = 2.62; 95% CI 1.56–4.42; P < 0.001) and pars plana vitrectomy (HR = 1.85; 95% CI 1.20–2.83; P = 0.005) were associated with an increased risk. Subgroup analysis showed that in non‐diabetic patients, male gender (HR = 1.63; 95% CI 1.04–2.57; P = 0.03) was an additional risk factor and in diabetic patients there was no significant association between diabetes type, duration or retinopathy grade and the risk of Nd:YAG capsulotomy. Conclusion: Although diabetes mellitus appears to be associated with a lower long‐term incidence and a decreased risk of Nd:YAG capsulotomy, younger age, pars plana vitrectomy, postoperative inflammation, plate‐haptic silicone and PMMA IOLs in addition to male gender in non‐diabetic patients appear to be associated with a greater risk. Estimation of the incidence and risk factors of PCO should help in patient counselling and to design methods to reduce or prevent its development.</abstract><subject lang="en"><genre>keywords</genre><topic>capsulotomy</topic><topic>cataract</topic><topic>diabetes mellitus</topic><topic>incidence</topic><topic>intraocular</topic><topic>lens</topic><topic>Nd:YAG</topic><topic>phacoemulsification</topic></subject><relatedItem type="host"><titleInfo><title>Clinical & Experimental Ophthalmology</title></titleInfo><genre type="journal">journal</genre><identifier type="ISSN">1442-6404</identifier><identifier type="eISSN">1442-9071</identifier><identifier type="DOI">10.1111/(ISSN)1442-9071</identifier><identifier type="PublisherID">CEO</identifier><part><date>2006</date><detail type="volume"><caption>vol.</caption><number>34</number></detail><detail type="issue"><caption>no.</caption><number>6</number></detail><extent unit="pages"><start>526</start><end>534</end><total>9</total></extent></part></relatedItem><identifier type="istex">F6C4228C5A4E572E0AB6ECF415384BFDFE4473FE</identifier><identifier type="DOI">10.1111/j.1442-9071.2006.01263.x</identifier><identifier type="ArticleID">CEO1263</identifier><recordInfo><recordContentSource>WILEY</recordContentSource><recordOrigin>Blackwell Publishing Asia</recordOrigin></recordInfo></mods></metadata><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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