Incidence of Nd:YAG laser capsulotomies after cataract surgery: comparison of 3 square-edged lenses of different composition

Objective: To compare the incidence of Nd:YAG laser treatment following 3 square-edged intraocular lenses (IOLs) of different composition implanted during cataract surgery. Design: Patient chart analysis. Participants: Patients aged 50-85 years and given a hydrophobic acrylic IOL (either SA60AT or AR40E) or hydrophilic acrylic IOL (XL-Stabi) were included. Analysis was conducted of 767 eyes treated with SA60AT (n = 250), AR40E (n = 254), or XL-Stabi (n = 263). Methods: This retrospective study involved patients who had undergone cataract surgery between 2001 and 2002. Ophthalmology centres were accepted into the study if they used at least 2 of the IOLs being investigated. The medical files of patients fulfilling the inclusion criteria were listed, and eligible cases were selected randomly. Patients' characteristics were obtained from their medical files. Data on postsurgical complications and Nd:YAG laser treatment over 3 years were also extracted. Follow-up data were obtained from the medical files and the patients' ophthalmologists. Time to Nd:YAG laser treatment was analysed using Kaplan-Meier survival curves adjusted with a Cox model. Results: After 3 years' follow-up the proportions of patients who had not received Nd:YAG laser treatment were 87.0% with SA60AT 76.6% with AR40E, and 54.6% with XL-Stabi (p < 0.00 1). Cox's model adjusted for centre effects and the presence of diabetes estimated risk ratios of 2.8 for AR40E (p < 0.0005) and 5.1 for XL-Stabi (p < 0.0001), compared with the reference lens SA60AT. Conclusions: Of the 3 square-edged lenses studied, the SA60AT was associated with a lower incidence of Nd:YAG laser treatment than either AR40E or XL-Stabi.