What does this research mean for the field?

YAG laser capsulotomy in patients with nonproliferative diabetic retinopathy is associated with an increased risk of progression to proliferative diabetic retinopathy and other vision-threatening complications. Novelty: ClaimNovelty.NOVEL_FINDING. Consensus alignment: ConsensusAlignment.CHALLENGES_CONSENSUS.

What question did this study set out to answer?

This research aims to assess the risk of progression in diabetic retinopathy (DR) following YAG laser capsulotomy in patients with nonproliferative DR after cataract surgery.

February 22, 2026

Risk of diabetic retinopathy progression after YAG laser capsulotomy

Key Points

This research aims to assess the risk of progression in diabetic retinopathy (DR) following YAG laser capsulotomy in patients with nonproliferative DR after cataract surgery.
Conducted a retrospective cohort study using electronic health records from U.S. healthcare organizations.
Included patients aged 18 or older with type 1 or 2 diabetes and nonproliferative DR.
Matched patients who underwent YAG laser capsulotomy with a control group without the procedure.
Evaluated outcomes after one year, focusing on the development of proliferative DR and other complications.
Patients treated with YAG laser demonstrated a higher risk of developing proliferative DR (HR 1.91).
The incidence of vitreous hemorrhage was increased (HR 1.40) after YAG treatment.
Risk of tractional retinal detachment was elevated (HR 2.04).
Need for panretinal photocoagulation was also higher in YAG-treated eyes (HR 1.48).
Similar risk patterns were noted in patients with a longer history of nonproliferative DR.

Abstract

Purpose: To evaluate the risk of diabetic retinopathy (DR) progression and associated ophthalmic complications after YAG laser capsulotomy in patients with nonproliferative DR (NPDR) after cataract surgery. Setting: Multicenter study using deidentified electronic health records from 69 U.S. healthcare organizations across outpatient and academic ophthalmology settings. Design: Retrospective cohort study using propensity score matching to balance baseline characteristics. Methods: Patients aged 18 years or older with type 1 or 2 diabetes and NPDR who underwent cataract surgery with or without subsequent YAG laser capsulotomy were identified. Patients were followed for 1-year postcataract surgery. Exclusion criteria included less than 6 months of follow-up. Primary outcomes included development of proliferative DR (PDR), vitreous hemorrhage (VH), tractional retinal detachment (TRD), neovascular glaucoma, and need for panretinal photocoagulation (PRP) or pars plana vitrectomy. Results: 10 750 patients (10 750 eyes) were included after matching: 5375 YAG-treated and 5375 control eyes. At 1 year, YAG-treated patients had higher risk of PDR (hazard ratio HR, 1.91; 95% CI, 1.67-2.18), VH (HR, 1.40; 95% CI, 1.15-1.72), TRD (HR, 2.04; 95% CI, 1.32-3.13), and PRP (HR, 1.48; 95% CI, 1.14-1.91). A secondary analysis of patients with ≥5 years of NPDR showed similar elevated risks. Conclusions: YAG laser capsulotomy in patients with NPDR is associated with increased risk of DR progression and vision-threatening complications. Ophthalmic screening and close follow-up are recommended in this population after YAG treatment.

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Cite This Study

Alshaikhsalama et al. (Fri,) studied this question.

synapsesocial.com/papers/699a9da0482488d673cd38e6 https://doi.org/https://doi.org/10.1097/j.jcrs.0000000000001813

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