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Updated: Aug 12, 2026
Rotating the Intraocular Lens to Prevent Posterior Capsular Opacification in Cataract Surgeries
Published on: July 7, 2023
Mathematical model to predict the need for neodymium: YAG capsulotomy based on posterior capsule opacification rate
D S Clark1, M F Munsell, J M Emery
1Medarex, Annandale, New Jersey 08801-0953, USA.
Purpose:
To evaluate a model to project the estimated time required before patients having primary phacoemulsification require neodymium:YAG (Nd:YAG) laser capsulotomy.
Setting:
Eleven private practices in the United States.
Methods:
Projections of time to capsulotomy were based on assessment of the early development of posterior capsule opacification (PCO) over time. The PCO data were collected during a clinical study to evaluate MDX-RA, an investigational immunotoxin designed to limit epithelial cell growth, preventing postsurgical PCO. From the PCO data, the estimated time to Nd:YAG capsulotomy in a placebo-treated group was compared with the actual time to capsulotomy in a cohort of patients from general practice who had had phacoemulsification.
Results:
By 6 months, the mean Opacification Index in the MDX-RA group was significantly lower than that in the placebo group (P < .05) and it remained significantly lower at 12 (P < .001), 18 (P < .001), and 24 (P < .016) months. The rate of PCO in the MDX-RA group was approximately 6 times lower than that in the placebo group (P < .0004). Fifty-seven percent in the placebo group and 4% in the MDX-RA group were projected to require an Nd:YAG capsulotomy within 3 years of primary cataract surgery. Projected values for the placebo group were similar to actual values observed in the population-based cohort.
Conclusions:
This technique could be used to predict the need for Nd:YAG capsulotomy using early measurements of PCO.
