Five-Year Incidence of Nd:YAG Capsulotomy After Cataract Surgery with Different Single-Piece Monofocal Intraocular Lenses: A Follow-Up Study of 3955 Eyes.

ABSTRACT

Purpose: To estimate the incidence of neodymium-doped yttrium aluminum garnet laser (NdYAG) capsulotomy up to five years after cataract surgery with different single-piece acrylic monofocal IOLs in a Spanish cohort. Patients and Methods: Data were extracted from electronic medical records. Eligible participants were aged ≥65, had cataract surgery with one of five different acrylic monofocal IOLs (Alcon AcrySof, AJL LLASY60, Medicontur Bi-flex, IOL Tech Stabibag and Zeiss Asphina), and more than six months baseline data. Participants were followed up to five years from surgery and up to six months from NdYAG. The incidence of NdYAG was compared between the IOLs and multivariate analyses were conducted to identify predictors of NdYAG incidence at five-years after cataract surgery. Results: The initial cohort included 9545 patients with 14,519 eyes (53% female, average age 75 years). Of those, 3955 eyes were available for analysis five years after cataract surgery. Throughout the five years post-surgery, NdYAG incidence was consistently lower with Alcon Acrysof IOLs than the other IOLs. At five years the NdYAG incidence rate for Alcon Acrysof was 8.8%. In comparison, the incidence was 47.4% for AJL LLASY60 (OR = 9.54, 95% CI [6.57, 13.84]), 44.3% for Zeiss Asphina (OR = 8.35, 95% CI [5.85, 11.94]) and 44.0% for IOL Tech Stabibag (OR = 8.02, 95% CI [4.60, 13.84]). Conclusion: Alcon AcrySof IOLs have a consistently lower risk of NdYAG incidence over a long follow-up period after cataract surgery, highlighting the importance of IOL choice for patients' long-term outcomes.