Long-Term Follow-Up of Adverse Consequences after Nd:YAG Laser Treatment for Posterior Capsular Opacification

PURPOSE: To evaluate the long-term follow-up of adverse effects after neodymium: yttrium-aluminum-garne (Nd:YAG) laser treatment for posterior capsular opacification (PCO). METHODS: In this study, 152 patients (184 eyes) diagnosed with PCO and who received Nd:YAG laser posterior capsulotomy with at least 5 years of follow-up were retrospectively analyzed to evaluate the clinical adverse consequences after Nd:YAG laser posterior capsulotomy. RESULTS: The mean age in the study group was 63.2 +/- 4.2 years and the mean follow-up period was 6.2 +/- 0.6 years. Vitreous floaters (8.1%) were the most common complication followed by reactive anterior uveitis (5.9%) and transient increase in intraocular pressure of more than 30 mm Hg (5.4%). Other complications included primary Nd:YAG laser failure (2.7%), recurrent lens epithelial remnant proliferation (1.6%), cystoid macular edema (1.1%), corneal edema (0.5%), retinal tear (0.5%), and rhegmatogenous retinal detachment (0.5%). CONCLUSIONS: Although Nd:YAG laser treatment is the most effective and safe method, surgeons should be aware of the occasional complications such as recurrent lens epithelial remnant proliferation, retinal tear, and rhegmatogenous retinal detachment through long-term follow-up.

The Effect of Two Different Opening Patterns of Neodymium:YAG Laser Posterior Capsulotomy on Visual Function

PURPOSE: To investigate the effects of two different opening patterns in neodymium:yttrium-aluminum-garnet (Nd:YAG) laser posterior capsulotomy on visual function. METHODS: A randomized prospective study was conducted on 62 pseudophakic eyes from 50 patients with posterior capsular opacification (PCO). Groups A and B underwent laser posterior capsulotomy with a cruciate opening and a modified circular opening, respectively. The best corrected visual acuity (BCVA), contrast sensitivity, and glare sensitivity were measured before and after laser posterior capsulotomy in both groups. The occurrences of intraocular lens (IOL) pittings were investigated and compared between the two groups. RESULTS: After laser capsulotomy, there were significant increases in BCVA, contrast and glare sensitivity in both groups and no significant differences between the two groups. However, group A had significantly more patients with three or more IOL pittings within a 1.5-mm radius from the IOL center (p = 0.047). In group A, these patients had significantly less contrast sensitivity (p = 0.023 in 1.6 cpd) and glare sensitivity (p = 0.043 in 1.6 cpd) than did patients with two or fewer IOL pittings. CONCLUSIONS: Nd:YAG laser posterior capsulotomy using a modified circular opening can be considered an effective method to manage PCO.