TOPLINE:

In patients with nonproliferative diabetic retinopathy who underwent cataract surgery, yttrium aluminum garnet (YAG) laser capsulotomy was associated with increased risks for progression of the disease and the development of other complications that could threaten vision.

METHODOLOGY:

• Researchers conducted a retrospective cohort study to evaluate whether YAG laser capsulotomy was associated with progression of diabetic retinopathy or occurrence of related complications.
• They used electronic health records from 69 healthcare organizations in the US and included adults with type 1 or type 2 diabetes and nonproliferative diabetic retinopathy who underwent cataract surgery.
• The final analysis included 5375 eyes that underwent YAG laser capsulotomy after cataract surgery (mean age, 71.7 years; 57.7% women), propensity score matched with an equal number of eyes that did not undergo the procedure.
• The primary outcome was the development of proliferative diabetic retinopathy. Secondary outcomes included the occurrence of other complications that could threaten vision, analyzed both separately and as a composite outcome.
• The follow-up duration was 1 year.

TAKEAWAY:

• At 1 year, patients who underwent YAG laser capsulotomy had a 91% higher risk for progressing to proliferative diabetic retinopathy than those who did not undergo the procedure (hazard ratio [HR], 1.91; 95% CI, 1.67-2.18).
• Patients who underwent the YAG procedure were more likely than those who did not to need panretinal photocoagulation (HR, 1.48; 95% CI, 1.14-1.91) and had higher risks for scar tissue pulling away the retina (HR, 2.04; 95% CI, 1.32-3.13), neovascular glaucoma (HR, 1.45; 95% CI, 1.08-1.94), and vitreous bleeding (HR, 1.40; 95% CI, 1.15-1.72).
• The risk for the composite outcome encompassing eye-related complications and interventions was significantly elevated among patients who underwent YAG laser capsulotomy.

IN PRACTICE:

“This report highlights how YAG in [diabetic retinopathy] eyes may unmask or hasten progression despite prior therapy and require the need for additional intervention,” the researchers of the study reported. “Ophthalmic screening and close follow-up are recommended in this population following YAG treatment,” they added.

SOURCE:

This study was led by Ahmed M. Alshaikhsalama, MD, of UT Southwestern Medical Center, Dallas. It was published online on October 29, 2025, in Journal of Cataract & Refractive Surgery.

LIMITATIONS:

The use of diagnostic codes may have introduced inaccuracy. Data on clarity of vision were unavailable. The experience of the surgeon was not accounted for.

DISCLOSURES:

This study did not receive any specific funding. Three authors reported serving as consultants, speakers, lecturers, and/or receiving grants from various pharmaceutical, biotechnology, and healthcare or eye care companies, including Allergan/AbbVie, Apellis Pharmaceuticals, and EyePoint Pharmaceuticals.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.