Baratz K H, Cook B E, Hodge D O
Department of Ophthalmology, Mayo Clinic, 200 First St., Rochester, MN 55905, USA.
Am J Ophthalmol. 2001 Feb;131(2):161-6. doi: 10.1016/s0002-9394(00)00795-9.
To estimate the cumulative probability of Nd:YAG laser posterior capsulotomy after cataract extraction in a geographically defined population.
Rochester Epidemiology Project databases were used to identify retrospectively all Nd:YAG laser posterior capsulotomies performed on Olmsted County, Minnesota, residents who had previously undergone cataract extraction between 1988 and 1996, inclusive. Demographic data and potential risk factors for laser, including age, sex, surgical technique, year of surgery, and intraocular lens material, were obtained by chart review or by retrieval from computer databases. The cumulative probability of Nd:YAG laser posterior capsulotomy was calculated by Kaplan-Meier estimates, and risk factors were analyzed using the Cox proportional hazards model.
A total of 925 Nd:YAG laser posterior capsulotomies were identified after 3541 cataract extractions in 2718 patients. The cumulative probability of Nd:YAG laser posterior capsulotomy after cataract surgery was 6% (95% confidence interval = 5% to 7%) at 1 year, increasing to 38% (35% to 40%) at 9 years. Young age at the time of surgery (P =.02), polymethylmethacrylate intraocular lens material (P <.001), earlier year of surgery (P <.001), and extracapsular extraction (in comparison with phacoemulsification, P <.001) were found to increase significantly the risk of subsequent Nd:YAG laser posterior capsulotomy. Women tended to have a greater probability of Nd:YAG laser posterior capsulotomy (P =.17), but this difference was not statistically significant.
Nd:YAG laser posterior capsulotomy was common after cataract surgery but infrequent during the first postoperative year. Prolonged follow-up is necessary in investigations of the effects of new cataract surgery technologies on the probability of capsulotomy.
评估在一个特定地理区域人群中白内障摘除术后钕：钇铝石榴石激光后囊切开术的累积概率。
利用罗切斯特流行病学项目数据库，回顾性识别1988年至1996年（含）期间在明尼苏达州奥尔姆斯特德县接受过白内障摘除术的居民所进行的所有钕：钇铝石榴石激光后囊切开术。通过病历审查或从计算机数据库检索获取人口统计学数据以及激光治疗的潜在风险因素，包括年龄、性别、手术技术、手术年份和人工晶状体材料。采用Kaplan-Meier估计法计算钕：钇铝石榴石激光后囊切开术的累积概率，并使用Cox比例风险模型分析风险因素。
在2718例患者的3541次白内障摘除术后，共识别出925例钕：钇铝石榴石激光后囊切开术。白内障手术后钕：钇铝石榴石激光后囊切开术的累积概率在1年时为6%（95%置信区间 = 5%至7%），9年时增至38%（35%至40%）。手术时年龄较轻（P = 0.02）、聚甲基丙烯酸甲酯人工晶状体材料（P < 0.001）、较早的手术年份（P < 0.001）以及囊外摘除术（与超声乳化术相比，P < 0.001）被发现显著增加了后续钕：钇铝石榴石激光后囊切开术的风险。女性接受钕：钇铝石榴石激光后囊切开术的概率往往更高（P = 0.17），但这种差异无统计学意义。
钕：钇铝石榴石激光后囊切开术在白内障手术后很常见，但在术后第一年并不频繁。在研究新的白内障手术技术对囊切开术概率的影响时，需要进行长期随访。
