Early-Onset Posterior Capsule Opacification: Incidence, Severity, and Risk Factors

Introduction To evaluate the incidence, severity, and risk factors of early-onset posterior capsule opacification (PCO) following uneventful phacoemulsification and intraocular lens (IOL) implantation. Methods Patients with cataracts who underwent phacoemulsification and IOL implantation surgery for 3 months from September 2019 to April 2020 were enrolled. All the subjects completed a comprehensive ocular examination. Retroillumination images of the posterior capsule were obtained using a slit lamp with imaging system, and PCO was graded by two ophthalmologists. Univariate and multivariate logistic regression analyses were performed to assess the risk factors for PCO. Results A total of 1039 subjects were enrolled, with mean age 66.68 +/- 11.43 years and 42.06% were male. The incidence of early-onset PCO in the 3 months after cataract surgery was 29.93%, and PCO of grade 3 and grade 4 was present in 31 patients (2.98%). Patients with complicated cataract had a higher incidence of PCO than age-related cataract, especially for patients with previous pars plana vitrectomy (PPV) surgery (P < 0.001). Moreover, the incidence of PCO increased with the deficiency of capsulorhexis-IOL overlap (P < 0.001). Multivariate logistic regression also showed that previous PPV surgery (OR 2.664, P = 0.003) and incomplete capsulorhexis-IOL overlap were risk factors for PCO (180-360 degrees overlap: OR 2.058, P < 0.001; < 180 degrees overlap: OR 5.403, P < 0.001). Conclusions Larger capsulorhexis and PPV surgery history contribute to the occurrence of early-onset PCO, indicating that primary posterior continuous curvilinear capsulorhexis can be considered during cataract surgery for patients with PPV history.

Automated summary

This study evaluated the incidence, severity, and risk factors of early-onset PCO following cataract surgery, finding that larger capsulorhexis and a history of PPV surgery contribute to the occurrence of PCO.