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06.09.2021 | original article

Outcomes of YAG anterior capsulotomy and surgical capsulectomy in the management of anterior capsular contraction syndrome

Zeitschrift:
Spektrum der Augenheilkunde
Autoren:
FRCOphth George Moussa, MD Konstantinos Katsikatsos, FRCOphth, MBA Soon Wai Ch’ng, MD, MSc, PhD Dimitrios Kalogeropoulos, BSc, MBBS, MRCS, PGCHE, FHEA, FRCOphth Jesse Panthagani, FRCOphth Kim Son Lett, FRCOphth Sreekanth Sreekantam, PGCertMedEd (Health), FEBOphth FRCOphth (London), FEBOS (Glaucoma) Imran Masood, FRCS (Ed), FRCOphth, MSc (Warwick) Velota C. T. Sung, MSc, FEBO, FRCOphth Walter Andreatta
Wichtige Hinweise
Author roles: All authors have made substantial contributions to the following: (1) the conception and design of the study, or acquisition of data, or analysis and interpretation of data, (2) drafting the article or revising it critically for important intellectual content, (3) final approval of the version to be submitted.

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Summary

Background

To primarily measure the visual acuity (VA) outcomes and, secondarily, the baseline characteristics and complication rate of YAG anterior capsulotomy (AC, YAGAC) compared to surgical anterior capsulectomy in patients with anterior capsular contraction syndrome.

Material and methods

Retrospective consecutive case series attending the Birmingham and Midlands Eye Centre.

Results

A total of 141 eyes were included (YAGAC: 108 and surgical AC: 33). The surgical AC group had a higher proportion of uveitis than the YAGAC group (eight [24.2%] and two [1.9%] respectively, p < 0.001). In the YAGAC group seven eyes (6.5%) required further laser and one eye (0.9%) needed surgical AC. No patients from the surgical group required further treatment. Median logMAR pre-operative VA was worse in the surgical AC: 0.45 (IQR 0.00–1.19) than in the YAGAC group: 0.12 (interquartile range [IQR] 0.00–0.38, p < 0.001). Both groups had no difference in final VA as the surgical group had a greater VA gain (p = 0.004).
Although the cystoid macular oedema rate was higher in the surgical group (three [9.1%]) than the YAGAC group (one [0.9%], p = 0.040), there was no significant difference in number of complications between the two groups (p = 0.074). No instances of intraocular lens subluxation were recorded in the YAGAC group, while two cases (6.1%) occurred in the surgical group (p = 0.053).

Conclusion

YAGAC and surgical AC lead to good visual outcomes with no differences in final VA between the two groups. The authors also showed low complication rates in both groups. This study will help surgeons in appropriately consenting patients presenting with ACCS when discussing both the YAG and the surgical AC treatment option.

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