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The predictors of posterior capsular opacification after refractive lens exchange.

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Posterboard#: B0380

Abstract Number: 2082 - B0380

AuthorBlock: Tianyi Zhang1, Julie Schallhorn1
1University of California San Francisco, San Francisco, California, United States;

DisclosureBlock: Tianyi Zhang, None; Julie Schallhorn, None;

Purpose
Posterior capsular opacification (PCO), the most frequent complication of cataract surgery, has not been well described following refractive lens exchange (RLE). This study investigated preoperative risk factors to identify predictors of the onset of PCO after RLE.

Methods
The study is a retrospective case-control study. All patients underwent RLE between 7/1/14 and 6/30/16 at a large RLE practice. Patients were included if they had preoperative best corrected visual acuity (BCVA) equal to or better than 20/40. A multivariable Cox proportional hazards regression model was constructed to evaluate the impact of preoperative factors on the development of PCO.

Results
A total of 10,296 patients (18,110 eyes) underwent RLE during the study period. There were 748 occurrences of PCO in 748 eyes. In the regression model, age, preoperative manifest spherical equivalent (MSE) and surgeon caseload were found to be significant contributors to the development of PCO. One unit (D) increase in preoperative manifest spherical equivalent was associated with a 7.2% reduction in hazard ratio (HR) of developing PCO (HR=0.928; 95% CI= 0.911 to 0.946; p <0.001). In addition, every additional surgical case per week for surgeons lead to a HR reduction of 1.7% (HR=0.983; 95% CI= 0.977 to 0.990; p <0.001). Every one-year increase in age of the patients was associated with a 1.3% reduced hazard of developing PCO (p=0.013). Lastly, females were found to have a 10.4% lower likelihood of developing PCO compared to males, but the difference was not statistically significant (HR=0.896; 95% CI= 0.771 to 1.040; p=0.14).

Conclusions
The development of PCO after RLE is associated with younger age, higher amounts of preoperative myopia, and lower surgeon volume.

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