DOI: http://dx.doi.org/10.18203/2349-3933.ijam20190108

Safety and efficacy of Nd:YAG laser capsulotomy in management of posterior capsular opacification

Pratima Sahu, Amit Kumar Mishra

Abstract


Background: At present, the only effective treatment of posterior capsular opacification (PCO), which is the most common complication of modern cataract surgery, is Neodymium-Yttrium Aluminum Garnet (Nd:YAG) laser capsulotomy. There are few complications associated with this easy and quick laser capsulotomy. The current study was conducted in a tertiary hospital of Odisha with an objective to find the safety and efficacy of Nd:YAG laser capsulotomy in the management of defective vision due to posterior capsular opacity.

Methods: The study was conducted among the patients attending the Ophthalmology out patient department of a tertiary hospital in Odisha with defective vision due to posterior capsular opacity after cataract surgery. Nd:YAG laser capsulotomy was carried out in all patients with significant PCO. Visual acuity and intraocular pressure were recorded before and after the procedure. The cases were carefully followed up and looked for any complication and visual acuity was assessed during follow up visits.

Results: In the study 184 participants were included. Visual improvement was observed in 97.8% participants. Visual acuity improved to 6/6 in 21.73 %, 6/9 in 36.41 % cases, 6/12 in 15.21 % cases. Raised IOP was recorded among 46% of participant after 4 hrs of laser capsulotomy which was later observed among 12% of participants on follow up visit at 1 week. The most common complication recorded was transient rise of IOP (46.3%) followed by aqueous flare (28.8%).

Conclusions: Nd:YAG laser capsulotomy is a noninvasive, effective, relatively safe procedure for PCO with good visual outcome.

Keywords


Intra ocular pressure, Nd:YAG laser, Posterior capsular opacity, Visual acuity

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References


National Program for Control of Blindness, Ministry of Health and Family Welfare, Government of India. Available from: http://npcb.nic.in/ Accessed on: 14 January 2019.

Apple DJ, Solomon KD, Tetz MR, Assia EI, Holland EY, Legler UF, et al. Posterior capsule opacification. Surv Ophthalmol. 1992;37(2):73-116.

Apple DJ, Peng Q, Visessook N, Werner L, Pandey SK, Escobar GM, et al. Eradication of posterior capsule opacification:documentation of a marked decrease in Nd:YAG laser posterior capsulotomy rates noted in an analysis of 5416 pseudophakic human eyes obtained postmortem. Ophthalmology. 2001;108(3):505-18.

Halilovic AE. Complications in the posterior eye segment after Nd: YAG laser capsulotomy. Med Arh. 2004;58:7-9.

Slomovic A, Parrish R. Acute elevations of intraocular pressure following Nd:YAG laser posterior capsulotomy. Ophthalmology. 1985;92(7):973-6.

Parker WT, Lorfeine GS. Yag Capsulotomy and IOP Rise. Ophthalmic Surg. 1984;15:787-92.

Gardner KM, Straatsma BR, Pettit TH. Neodymium:YAG laser posterior capsulotomy: the first 100 cases at UCLA. Ophthalmic Surg. 1985 Jan;16(1):24-8.

Stark WJ, Worthen D, Holladay JT, Murray G. Neodymium:YAG lasers. An FDA report. Ophthalmology. 1985 Feb;92(2):209-12.

Wasserman EL, Axt JC, Sheets JH. Neodymium:YAG laser posterior capsulotomy. J Am Intraocul Implant Soc. 1985 May;11(3):245-8.

Aslam TM, Devlin H, Dhillon B. Use of Nd:YAG laser capsulotomy. Surv Ophthalmol. 2003;48(6):594-612.

Billotte C, Berdeaux G. Adverse clinical consequences of neodymium:YAG laser treatment of posterior capsule opacification. J Cataract Refract Surg. 2004;30(10):2064-71.

Bath PE, Hoffer KJ, Aron-Rosa D, Dang Y. Glare disability secondary to YAG laser intraocular lens damage. J Cataract Refract Surg. 1987;13:309-13.

Keates RH, Steinert RF, Puliafito CA, Maxwell SK. Long-term follow-up of Nd:YAG laser posterior capsulotomy. J Am Intraocul Implant Soc. 1984;10:164-8.

Winslow RL, Taylor BC. Retinal complications following YAG laser capsulotomy. Ophthalmology. 1985;92:785-9.

Jampol LM. Cystoid macular edema following cataract surgery. Arch Ophthalmol. 1989;107(2):166-7.

Hasan KS, Adhi MI, Aziz M, et al. Nd:YAG Laser Posterior Capsulotomy. Pak J Ophthalmol. 1996;12:3-7.

Harris WS, Herman WK, Fagadau WR. Management of the posterior capsule before and after the YAG laser. Trans Ophthalmol Soc UK. 1985;104:533-5.

Gore VS. The study of complications of Nd:YAG laser capsulotomy. Klin Monbl Augenheilkd. 1994 May;204(5):286-7.

Rathod Darshana, Intraocular Pressure Variation After Nd:yag Laser Posterior Capsulotomy IJSR 2016:5(12):43-7.

Ge J, Wand M, Chiang R, Paranhos A, Shields B. Long termeffect of Nd: YAG laser posterior capsulotomy on intraocular pressure. Arch Ophthalmol. 2000:118(10):1334-7.

Aron-Rosa D, Aron JJ, Griesemann M, Thyzel R. Use of the neodymium-YAG laser to open the posterior capsule after lens implant surgery: a preliminary report. J Am Intraocul Implant Soc. 1980;6(4):352-4.

Gore VS. The study of complications of Nd:YAG laser capsulotomy. Klin Monbl Augenheilkd. 1994;204(5):286-7.

Barnes EA, Murdoch IE, Subramaniam S, Cahill A, Kehoe B, Behrend M. Neodymium:yttrium-aluminum-garnet capsu-lotomy and intraocular pressure in pseudophakic patients with glaucoma. Ophthalmol. 2004;111(7):1393-7.

Ladas ID, Baltatzis S, Panagiotidi SD, Zafiraki SP, Kokolakis SN, Theodossiadis GP. Topical 2.0% dorzolamide vs oral acetazolamide for prevention of intraocular pressure rise after neodymium:YAG laser posterior capsulotomy. Arch Ophthalmol 1997;115(10):1241-4.

Minello AA, Prata Junior JA, Mello PA. Efficacy of topic ocular hipotensive agents after posterior capsulotomy. Arq Bras Oftalmol 2008;71(5):706-10.

Sesar A, Petric I, Sesar I, Lacmnovic-Loncar V, Jurisić D, Tomić Z, et al. Intraocular pressure after ND: YAG laser capsulotomy in pseudophakic patients with glaucoma. Acta Med Croatica. 2006;60(2):109-12.

Chen TC, Ang RT, Grosskreutz CL, Pasquale LR, Fan JT. Brimonidine 0.2% versus apraclonidine 0.5% for prevention of intraocular pressure elevations after anterior segment laser surgery. Ophthalmol. 2001 Jun 1;108(6):1033-8.

Rakofsky S, Koch DD, Faulkner JD, Terry SA, Mandell AI, Gross RL, et al. Levobunolol 0.5% and timolol 0.5% to prevent intraocular pressure elevation after neodymium:YAG laser posterior capsulotomy. J Cataract Refract Surg. 1997;23(7):1075-80.

Terry AC, Stark WJ, Maumenee AE, Fagadau W. Neodymium- YAG laser for posterior capsulotomy. Ame J Ophthalmol. 1983;96:716-20.

Flohr MJ, Robin AL, Kelley JS. Early complication following QSwitched Neodymium -YAG laser posterior capsulotomy. Ophthalmol. 1985;92:360-3.

Nirankari VS, Richards RD. Complications associated with the use of the Neodymium-YAG laser. Ophthalmol. 1985;92:1371-5.

Smiddy WE, Radulovic D, Yeo JH, Stark WJ, Maumenee AE. Potential acuity meter for predicting visual acuity after Nd-YAG posterior capsulotomy. Ophthalmol. 1986;93:397-400.