YAG Capsulotomy Adverse Events Highlight A Need For Close Follow-Up

Individuals who undergo neodymium:yttrium aluminum garnet capsulotomy (nd:YAG-caps) may experience adverse events (AEs) including ocular hypertension (OHT), macular edema (ME), and retinal detachment, according to an investigation published in Ophthalmology. Patients with diabetes and individuals undergoing the procedure within a year of cataract removal are at increased risk of these adverse events, the report shows.   

Researchers included 6210 patients (mean age, 75.0 years; 65.3% women) who underwent 7958 nd:YAG-caps procedures between 2014 and 2017 in the observational cohort analysis. The team assessed OHT, ME, and retinal detachment rates every 3 months during the 1-year study duration.  

A total of 13.3% of participants experienced at least 1 AE — 68.4% experienced it within the first 3 months, according to the report. OHT was the most common adverse event (9.6%), followed by ME (6.4%), and retinal detachment (<1%) at 12 months. Patients who underwent nd:YAG-caps within a year of undergoing cataract surgery had an increased risk of experiencing adverse events compared with individuals who underwent nd:YAG-caps later than 1 year following the procedure (hazard ratio [HR], 1.314; P =.0256). Individuals with diabetes had a higher risk of OHT (HR, 1.233; P =.0448) and ME (HR, 1.820; P <.0001).   

“Whether when considering the rates of the 3 AE of interest overall or individually, the time between cataract surgery and Nd:YAG-caps appeared as one of the most important drivers for AE occurrence, with a short period (less than 2 years) between these procedures appearing as a risk factor,” according to the study authors. “As post-cataract AE are slightly similar to post-Nd:YAG-caps ones, notably ME and OHT/Glaucoma, the proximity of cataract and Nd:YAG-caps could potentiate their iatrogenic effect, increasing the risk of AE. These findings highlight the importance of correcting all the known [posterior capsular opacification] factors that can be improved.”

Study limitations include the observational nature and potential for miscoding. 

Disclosure: This research was supported by Alcon. Multiple study authors declared affiliations with biotech, pharmaceutical, and/or clinical research organizations. Please see the original reference for a full list of authors’ disclosures.