Analysis of systemic and ophthalmic risk factors of posterior capsule opacity after cataract surgery

Purpose: Determination and analysis of systemic and ocular risk factors in the development of posterior capsule opacity in patients who have undergone FAKO surgery. Materials and Methods: This research was performed on patients who applied to Rize Recep Tayyip Erdogan University Education and Research Hospital Ophthalmology Clinic between January 2015 and December 2021.This study was performed on patients, who underwent phacoemulsification (FACO) surgery without complications with a diagnosis of cataract and whose intraocular lens (IOL) implantation was performed and in posterior process who developed back capsule opacification (ACO) (study group) who did not developed (control group). The study included 180 eyes of 150 patients in the study group and 113 eyes of 94 patients in the control group. The data used in the study were collected by archival search using the patients' files and imaging records. Statistical analysis of the study data was performed with SPSS IBM 29.0.0 package program. Results: 180 of the patients included in the study were in group one (developed back capsule opacification (ACO); working group), while 113 in second group (did not develop back capsule opacification (ACO); study group). Akoz depth (AD) averaged 2.61 ± 0.36 mm in the group with ACO and in the group without ACO averaged 2.75 ± 0.41 mm. Anterior chamber depth (ACD) averaged 3.13 ± 0.43 mm in the ACO group and 3.28 ± 0.40 mm in the ACO-free group. In AD and ACD statistically significant difference was found (p:0.021 and p:0.010, respectively). In the distribution of comorbidities in the patients, 16 patients in the group with ACO (8.9%) had rheumatologic disease. In the non-ACO group, 2 patients (1.8%) had rheumatologic disease. The frequency of rheumatologic diseases (p=0.014) was significant. In patients in AKO developed group, primary open angle glaucoma (POAG) was detected in 11 patients (6.1%) and in 18 patients (15.9%) in the AKO non-development group. In AKO non-developed group primary open-angle glaucoma was significantly more common in comparison with the group that developed primary open-angle glaucoma (p=0.006). In the xi ROC analysis with the continuous parameters of the study, there was not found a statistically significant correlation between the development of the posterior capsule opacity and age, IOL power, AXL, CCT, LT and WTW, whereas a significant correlation was found between AD and ACD. Conclusion: ACO is one of the most common causes of decreased vision in the postoperative period. AKO, although there is a treatment, because of causing vision loss in the patient, costly diagnosis and treatment process and possibility of the treatment method's leading to complications, is an undesirable side effect. In our study, we investigated the risk factors of ACO. We found a significant association between AD, low ACD, concomitant rheumatologic disease and the occurrence of ACO. As a result, eyes with AD, low ACD and comorbid disease, especially rheumatologic disease, have a higher risk of developing ACO after surgery. These patients need to be shown more care in terms of development of ACO during and after follow-up surgery. Keywords: Cataract, Phaco, Complications, Posterior capsule opacity, Nd YAG laser