Pmd1 - Post-Nd:yag Laser Complications in Cataract Patients Treated for Posterior Capsular Opacification: A Systematic Literature Review

O'Boyle, D.; Vives, C. Pérez; Samavedam, S.; Ender, F; deHaan, J.; Shaikh, J.; Saini, Lalit

doi:10.1016/j.jval.2018.09.1450

Cited by 5 publications

(4 citation statements)

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“…The ocular comorbidities included retinal vein occlusion (RVO), uveitis, diabetic retinopathy, prior Nd:YAG-caps , and cataract surgery, assessed over the same period. Finally, known Nd:YAG-caps complications were analyzed over a 1-year period before the index date and included Ocular hypertension (OHT) or glaucoma, retinal detachment (RD), vitrectomy, and treated diabetic macular edema (DME), age-related macular degeneration (ARMD), uveitis, or RVO [ 19 ]. Detailed algorithms are available as supplementary material.…”

Section: Methodsmentioning

confidence: 99%

Incidence of Nd:YAG laser capsulotomy following cataract surgery: a population-based nation-wide study – FreYAG1 study

Brézin,

Labbe,

Schweitzer

et al. 2023

BMC Ophthalmol

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Rationale Nd:YAG (neodymium:yttrium-aluminum-garnet) capsulotomy (Nd:YAG-caps) is the gold standard for the treatment of PCO (Posterior Capsule Opacification). There is a lack of real-world data about Nd:YAG-caps use. Purpose This study’s objectives were to estimate Nd:YAG-caps incidence in France, to describe the patient characteristics, and to analyze the time between surgeries and capsulotomies. Setting: The study was based on data extracted from the EGB database, a 1/97th sample representative of the French population. Design: observational, retrospective, cohort study using national claims data. Methods French adult patients who underwent Nd:YAG-caps between 2014 and 2017 were selected. Main outcomes were the number of patients and procedures performed and the risk factors associated with early Nd:YAG-caps. Results: During the study period, Nd:YAG-caps were performed in 8,425 patients accounting for 10,774 procedures. The extrapolation to the French population led to estimate that 253.103 patients had Nd:YAG-caps, representing 312.103 procedures in 2017. The mean age at Nd:YAG-caps was 75.1 (± 10.2) years. About 36% of patients presented at least one ocular comorbidity. Nd:YAG-caps was performed within 2 years after surgery in 33.0% of patients and within one year in 9.8% of patients. Patients with Nd:YAG-caps within the first year (OR CI95 0.721 [0.673–0.772]) or in the first two years (OR CI95 0.721 [0.673–0.772]) were younger than patients with later Nd:YAG-caps and had a more frequent history of treated ocular diseases (OR 1.516 and 1.178, respectively). Conclusions This study brought new real-world and large-scale data regarding Nd:YAG-caps use and gave an updated insight into the patients’ characteristics.

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Section: Methodsmentioning

confidence: 99%

Incidence of Nd:YAG laser capsulotomy following cataract surgery: a population-based nation-wide study – FreYAG1 study

Brézin,

Labbe,

Schweitzer

et al. 2023

BMC Ophthalmol

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“…The 3-year incidence of Nd:YAG laser capsulotomy after cataract surgery with single-piece monofocal acrylic AcrySof IOLs and comparator IOLs was derived from the post hoc analysis of the data available from a real-world evidence study 25. 3-year risk probability of post-Nd:YAG capsulotomy complications of RD, glaucoma, and CME were derived from the published rates in studies (retrieved through a systematic literature search) using weighted average and probability equation methodology 26. Various input parameters used for the analysis along with their sources have been illustrated in Figures 1 and 2.…”

Section: Methodsmentioning

confidence: 99%

“… Note: Three-year post-Nd:YAG capsulotomy risk probability of RD, glaucoma, and CME was estimated using weighted average of published rates from studies retrieved through a systematic literature search 26…”

Section: Figurementioning

confidence: 99%

Comparing the long-term impact on health care resources utilization and costs due to various single-piece acrylic monofocal intraocular lens implantation during cataract surgery: a cost-consequence analysis for the United Kingdom, Italy, and Denmark

Dhariwal

Bouchet

Jawla

2019

OPTH

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PurposeThe objective of this study was to estimate the cost impact of neodymium-doped yttrium aluminum garnet (Nd:YAG) laser capsulotomy and its complications due to single-piece acrylic monofocal intraocular lenses (IOLs) in the healthcare setting of United Kingdom, Italy, and Denmark.Materials and methodsA hypothetical cost-consequence model was developed to estimate economic burden of Nd:YAG laser capsulotomy due to different single-piece acrylic monofocal IOLs. Cumulative incidence of Nd:YAG laser capsulotomy at 3 years after cataract surgery with five single-piece monofocal acrylic IOLs was sourced from retrospective data analysis of electronic medical records of cataract patients in the United Kingdom. Risk probability of post-Nd:YAG laser complications, ie, retinal detachment, glaucoma, and cystoid macular edema at 3 years was derived using published literature. Unit costs were taken from publicly available sources with all costs converted to euro (€). Number of cataract procedures per year for each country was sourced from Eurostat statistics.ResultsFor the estimated cataract procedures carried out nationally every year, single-piece monofocal hydrophobic AcrySof IOL was associated with substantially lower cases of Nd:YAG laser capsulotomy procedures and subsequent complications in 3 years after cataract surgery when compared to other single-piece monofocal acrylic IOLs. The total cost savings with the use of AcrySof over other IOLs in countries assessed ranged from €0.5 to €4.7 million (vs AMO Tecnis) and €2.1 to €17.9 million (vs Rayner C-/Super-flex).ConclusionIncidence of Nd:YAG capsulotomy due to the choice of IOL could significantly affect healthcare budgets in the post-cataract surgery period. Our analysis indicates that single-piece monofocal AcrySof IOLs is the most cost-saving treatment option for health care systems when compared to other acrylic single-piece IOLs.

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“…Incidence of PCO ranges from <5% to 50%11 and recently was reported for monofocal single-piece IOLs to range between 7.1% and 22.6% at 5 years 12. The most common effective treatment of PCO is neodymium-doped yttrium aluminium garnet laser capsulotomy, which occasionally involves the following complications: elevated intraocular pressure, retinal detachment and endophthalmitis 13. Therefore, evaluation of clinically significant versus non-significant PCO is of clinical relevance.…”

Section: Introductionmentioning

confidence: 99%

Diagnostic accuracy of code-free deep learning for detection and evaluation of posterior capsule opacification

et al. 2022

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ObjectiveTo train and validate a code-free deep learning system (CFDLS) on classifying high-resolution digital retroillumination images of posterior capsule opacification (PCO) and to discriminate between clinically significant and non-significant PCOs.Methods and analysisFor this retrospective registry study, three expert observers graded two independent datasets of 279 images three separate times with no PCO to severe PCO, providing binary labels for clinical significance. The CFDLS was trained and internally validated using 179 images of a training dataset and externally validated with 100 images. Model development was through Google Cloud AutoML Vision. Intraobserver and interobserver variabilities were assessed using Fleiss kappa (κ) coefficients and model performance through sensitivity, specificity and area under the curve (AUC).ResultsIntraobserver variability κ values for observers 1, 2 and 3 were 0.90 (95% CI 0.86 to 0.95), 0.94 (95% CI 0.90 to 0.97) and 0.88 (95% CI 0.82 to 0.93). Interobserver agreement was high, ranging from 0.85 (95% CI 0.79 to 0.90) between observers 1 and 2 to 0.90 (95% CI 0.85 to 0.94) for observers 1 and 3. On internal validation, the AUC of the CFDLS was 0.99 (95% CI 0.92 to 1.0); sensitivity was 0.89 at a specificity of 1. On external validation, the AUC was 0.97 (95% CI 0.93 to 0.99); sensitivity was 0.84 and specificity was 0.92.ConclusionThis CFDLS provides highly accurate discrimination between clinically significant and non-significant PCO equivalent to human expert graders. The clinical value as a potential decision support tool in different models of care warrants further research.

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Pmd1 - Post-Nd:yag Laser Complications in Cataract Patients Treated for Posterior Capsular Opacification: A Systematic Literature Review

Cited by 5 publications

References 0 publications

Incidence of Nd:YAG laser capsulotomy following cataract surgery: a population-based nation-wide study – FreYAG1 study

Incidence of Nd:YAG laser capsulotomy following cataract surgery: a population-based nation-wide study – FreYAG1 study

Comparing the long-term impact on health care resources utilization and costs due to various single-piece acrylic monofocal intraocular lens implantation during cataract surgery: a cost-consequence analysis for the United Kingdom, Italy, and Denmark

Diagnostic accuracy of code-free deep learning for detection and evaluation of posterior capsule opacification

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