Nd:YAG capsulotomy is not a risk factor for retinal detachment after phacoemulsification cataract surgery

Uri Elbaz, Laura Hakkala, Idan Hecht, Asaf Achiron, Assaf Gershoni, Raimo Tuuminen*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Purpose: To evaluate the cumulative incidence and risk factors of pseudophakic retinal detachment (PRD) following phacoemulsification cataract surgery. Methods: Cataract surgeries performed between the years 2007 and 2016 at the Ophthalmology Unit of Kymenlaakso Central Hospital, Kotka, Finland, were included. The cumulative incidence of PRD was estimated through Kaplan–Meier analysis. Patient mortality was incorporated as one of the censoring events. Cox regression analyses were used to evaluate potential risk factors, including age, gender, intraocular lens (IOL) power and previous neodymium-doped yttrium aluminium garnet (Nd:YAG) laser capsulotomy. Results: A total of 17 688 eyes of 12 003 patients were included. The mean patient age at surgery was 75.2 ± 9.1 years with 63.5% females (n = 11 228). During the mean follow-up time of 4.3 ± 2.7 years, 83 laterality-matched PRDs were registered (incidence 0.11% per year). Univariate analyses showed that age (HR 0.93; 95% CI 0.92–0.95), male gender (HR 3.99; 95% CI 2.52–6.33) and IOL power (HR 0.86; 95% CI 0.83–0.90) were significantly associated with PRD (p < 0.001 for all) and remained significant in a multivariate analysis. Neither univariate (HR 1.45; 95% CI 0.82–2.54, p = 0.201) nor multivariate (HR 1.03; 95%CI 0.57–1.88, p = 0.919) analyses showed any association between Nd:YAG capsulotomy and PRD. Conclusions: Male gender, low IOL power and younger age were confirmed as risk factors for PRD after phacoemulsification surgery. Real-world evidence suggests that Nd:YAG capsulotomy does not increase the risk for PRD.

Original languageEnglish
Pages (from-to)e1018-e1026
JournalActa Ophthalmologica
Issue number7
StatePublished - Nov 2021


  • YAG capsulotomy
  • cataract surgery
  • laser capsulotomy
  • retinal detachment
  • risk factors


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