Dataset Information

Long-Term Outcomes of Posterior Capsular Opacification in Highly Myopic Eyes and Its Influencing Factors.

ABSTRACT:

Introduction

The purpose of this study was to evaluate the long-term outcomes of posterior capsular opacification (PCO) in highly myopic eyes and its influencing factors.

Methods

Patients undergoing phacoemulsification with intraocular lens implantation and followed up for 1-5 years were included in this prospective cohort study. The severity of PCO was evaluated using EPCO2000 software system, with the area of central 3.0 mm (PCO-3 mm) and within the capsulorhexis (PCO-C) both being analyzed. Percentage of eyes after Nd:YAG capsulotomy, as well as clinically significant PCO (defined as eyes with visual-impairing PCO or after capsulotomy), were also included as outcome variables.

Results

A total of 673 highly myopic eyes [axial length (AL) ≥ 26 mm] and 224 control eyes (AL < 26 mm) were analyzed. The mean follow-up time was 34.0 ± 9.0 months. PCO was more severe in highly myopic eyes compared with controls with regard to higher EPCO scores (P < 0.001 for both PCO-3 mm and PCO-C), higher capsulotomy rate (P = 0.001), higher clinically significant PCO rate (P < 0.001) and shorter PCO-free survival time (P < 0.001). Extreme myopia (AL ≥ 28 mm) would further aggravate PCO in terms of higher EPCO scores (PCO-3 mm: P = 0.017; PCO-C: P = 0.013) and higher clinically significant PCO rate (P = 0.024) compared with other myopic eyes. In highly myopic eyes, AL [odds ratio (OR) 1.124, P = 0.004] and follow-up duration (OR 1.082, P < 0.001) were independent risk factors for clinically significant PCO after cataract surgery.

Conclusion

Highly myopic eyes had more severe PCO in the long term. Longer AL and follow-up duration were associated with higher risk of PCO.

Clinical trial registration

The study was registered at ClinicalTrials.gov (NCT03062085).

SUBMITTER: He W

PROVIDER: S-EPMC10287617 | biostudies-literature | 2023 Aug

REPOSITORIES: biostudies-literature

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Publications

Long-Term Outcomes of Posterior Capsular Opacification in Highly Myopic Eyes and Its Influencing Factors.

He Wenwen W Cheng Kaiwen K Zhao Liangliang L Liu Shuyu S Huang Zhiqian Z Zhang Keke K Du Yu Y Zhou Xingtao X Lu Yi Y Zhu Xiangjia X

Ophthalmology and therapy 20230503 4

<h4>Introduction</h4>The purpose of this study was to evaluate the long-term outcomes of posterior capsular opacification (PCO) in highly myopic eyes and its influencing factors.<h4>Methods</h4>Patients undergoing phacoemulsification with intraocular lens implantation and followed up for 1-5 years were included in this prospective cohort study. The severity of PCO was evaluated using EPCO2000 software system, with the area of central 3.0 mm (PCO-3 mm) and within the capsulorhexis (PCO-C) both be ...[more]

PMID: 37138195

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Project description:ImportanceHigh myopia is a global concern due to its escalating prevalence and the potential risk of severe visual impairment caused by pathologic myopia. Using artificial intelligence to estimate future visual acuity (VA) could help clinicians to identify and monitor patients with a high risk of vision reduction in advance.ObjectiveTo develop machine learning models to predict VA at 3 and 5 years in patients with high myopia.Design, setting, and participantsThis retrospective, single-center, cohort study was performed on patients whose best-corrected VA (BCVA) at 3 and 5 years was known. The ophthalmic examinations of these patients were performed between October 2011 and May 2021. Thirty-four variables, including general information, basic ophthalmic information, and categories of myopic maculopathy based on fundus and optical coherence tomography images, were collected from the medical records for analysis.Main outcomes and measuresRegression models were developed to predict BCVA at 3 and 5 years, and a binary classification model was developed to predict the risk of developing visual impairment at 5 years. The performance of models was evaluated by discrimination metrics, calibration belts, and decision curve analysis. The importance of relative variables was assessed by explainable artificial intelligence techniques.ResultsA total of 1616 eyes from 967 patients (mean [SD] age, 58.5 [14.0] years; 678 female [70.1%]) were included in this analysis. Findings showed that support vector machines presented the best prediction of BCVA at 3 years (R2 = 0.682; 95% CI, 0.625-0.733) and random forest at 5 years (R2 = 0.660; 95% CI, 0.604-0.710). To predict the risk of visual impairment at 5 years, logistic regression presented the best performance (area under the receiver operating characteristic curve = 0.870; 95% CI, 0.816-0.912). The baseline BCVA (logMAR odds ratio [OR], 0.298; 95% CI, 0.235-0.378; P < .001), prior myopic macular neovascularization (OR, 3.290; 95% CI, 2.209-4.899; P < .001), age (OR, 1.578; 95% CI, 1.227-2.028; P < .001), and category 4 myopic maculopathy (OR, 4.899; 95% CI, 1.431-16.769; P = .01) were the 4 most important predicting variables and associated with increased risk of visual impairment at 5 years.Conclusions and relevanceStudy results suggest that developing models for accurate prediction of the long-term VA for highly myopic eyes based on clinical and imaging information is feasible. Such models could be used for the clinical assessments of future visual acuity.

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Dataset Information

Long-Term Outcomes of Posterior Capsular Opacification in Highly Myopic Eyes and Its Influencing Factors.

Introduction

Methods

Results

Conclusion

Clinical trial registration

Publications

Long-Term Outcomes of Posterior Capsular Opacification in Highly Myopic Eyes and Its Influencing Factors.

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