Effects of ND YAG Laser Capsulotomy on Intra ocular Pressure and Macular Thickness

AIM- This study was aimed to find the changes in macular thickness and intra-ocular pressure overtime after ND-YAG laser capsulotomy. Methods: 100 pts fulfilling the inclusion criteria were included in the study and underwent a detailed ophthalmic examination. Pts IOP and macular thickness was measured by goldmann applanation tonometery and ocular coherence tomography (OCT) respectively before performing the procedure. Each patient was called for follow up on day 1, 1 week, 4 weeks, 8 weeks and 12 weeks. During all the follow up visits complete eye examination, IOP measurement, and macular thickness measurement were noted. Results: For this study, a total of 100 eyes of 100 patients (54 males, 46 females) aged 18to 80 years (mean age 51.98±14.01 years) fulfilling the inclusion and exclusion criteria were enrolled in the study.IOP was significantly higher at all the follow-up intervals among those in whom >40 mJ energy was used as compared to those in whom <40 mJ energy was used Mean change in macular thickness was found to be significantly higher at day 1 and week 1 among those in whom >40 mJ energy was used as compared to those in whom <40mJ energy was used. However, at subsequent follow-up intervals, the difference was not significant statistically. Conclusion: Nd-YAG laser capsulotomy results in increased IOP and macular thickness which sustains upto a substantial period.Rise in IOP following Nd:YAG laser posterior capsulotomy is correlated with the amount of energy used.Change in macular thickness following Nd:YAG laser posterior capsulotomy is weakly/mildly correlated with the amount of energy used during the initial follow-up, however, subsequently it does not show a correlation with amount of energy used.

Influence of size of Nd:YAG capsulotomy on ocular biological parameters and refraction / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM:To investigate the influences of Nd:YAG laser capsulotomy with different size on visual acuity(VA), intraocular pressure(IOP), refraction, anterior chamber depth(ACD), and macular thickness(MT)in patients with posterior capsular opacification(PCO). <p>METHODS: In this retrospective, constantly study, 41 eyes of 41 patients treated with Nd:YAG laser posterior capsulotomy for PCO were divided into 2 groups according to the different incision sizes of capsulotomy: the patients received capsulotomy with the incision diameter less than or equal to 3.5mm were enrolled into group 1, while those received operation with incision diameter more than 3.5mm went to group 2. All patients were followed up before Nd:YAG laser capsulotomy, 1wk, 1 and 3mo after Nd:YAG laser capsulotomy, and the best-corrected visual acuity(BCVA), refraction, IOP, ACD, and MT were compared between two groups. <p>RESULTS: In both groups, BCVA were significantly improved postoperatively compared with base line(<i>P</i><0.001), but there was no significant difference between two groups(<i>P</i>>0.05). The diopter(SE)of the two groups were not significantly different before and after operation(<i>P</i>>0.05). Intraocular pressure in group 2 was higher than those in group1 at 1wk(<i>t</i>=-2.609, <i>P</i>=0.013). ACD decreased significantly at 1wk postoperatively(<i>P</i><0.01), but with no significant difference at 1 and 3mo(<i>P</i>>0.05). Both groups had increased macular thickness lightly at 1wk postoperatively, but with no statistical significance(<i>P</i>>0.05), and there was no significant difference between the two groups at 1wk, 1 and 3mo postoperatively(<i>P</i>>0.05). <p>CONCLUSION: The increase in intraocular pressure is more pronounced when the size of posterior capsulotomy was larger. However, the changes of BCVA, ACD, refraction, MT are not related with the incision size of posterior capsulotomy.

Two Cases of WIOL-CF(R) IOL Dislocation after Nd:YAG Laser Capsulotomy

PURPOSE: To report 2 cases of WIOL-CF(R) intraocular lens (IOL) (Gelmed International, Kamenne Zehrovice, Czech Republic) dislocation after neodymium-doped yttrium aluminum garnet (Nd:YAG) laser capsulotomy. CASE SUMMARY: A 78-year-old female was referred for IOL dislocation. She was implanted with WIOL-CF(R) IOL 18 months prior. Two months after WIOL-CF(R) implantation, she received Nd:YAG laser capsulotomy at a local clinic. Pars plana vitrectomy and transscleral fixation of IOL were performed. CONCLUSIONS: This is the first report of WIOL-CF(R) IOL dislocation after Nd:YAG laser capsulotomy in unvitrectomized eyes. When Nd:YAG laser capsulotomy is performed after WIOL-CF(R) IOL implantation, IOL dislocation should be considered even in unvitrectomized eyes.

Comparison of Nd:YAG Laser Capsulotomy Rates between Implantation of Two Different Aspheric Intraocular Lenses

PURPOSE: To compare neodymium-doped yttrium aluminum garnet (Nd:YAG) laser capsulotomy rates between 2 different aspheric intraocular lenses, SN60WF and MI-60, in patients who underwent cataract surgery. METHODS: This retrospective study included 404 eyes of 278 patients who were followed up for at least 6 months after cataract surgery. Gender, age, follow-up period and Nd:YAG laser capsulotomy rates between the 2 different intraocular lens groups were compared. RESULTS: The mean follow-up period was 28.1 months in the SN60WF group and 24.3 months in the MI-60 group and the mean age was 68.6 years and 71.3 years in each group, respectively. Follow-up period and age were significantly different between the 2 groups (p < 0.01). Nd:YAG laser capsulotomy rates were 5.6% (13 of 231 eyes) in the SN60WF group and 48% (83 of 173 eyes) in the MI-60 group. Nd:YAG laser capsulotomy rates were significantly higher in the MI-60 group (p < 0.01). Female gender and young age were associated with significantly increased Nd:YAG laser capsulotomy rates (p < 0.01); however, diabetes mellitus was not significantly associated with Nd:YAG laser capsulotomy rates. CONCLUSIONS: Nd:YAG laser capsulotomy rates were higher in the MI60 hydrophilic aspheric intraocular lens group than the SN60WF hydrophilic aspheric intraocular lens group.

Incidence and Risk Factors of Nd:YAG Capsulotomy in Adult Cataract Patients under 50 Years of Age According to Different Age Groups

PURPOSE: To evaluate the risk factors and incidence of neodymium-doped yttrium aluminium garnet (Nd:YAG) posterior capsulotomy due to posterior capsular opacification in adult cataract patients under 50 years of age according to different age groups. METHODS: We retrospectively studied 280 eyes that received phacoemulsification and intraocular lens implantation. The total observation period was 26.2 months on average. The subjects were divided into 3 different age groups, 20's, 30's and 40's to evaluate the incidence of posterior capsulotomy. Risk factors based on gender, age, type of cataract, type of intraocular lens (IOLs), axial length, existence of diabetes mellitus, history of ocular trauma, atopic dermatitis and refractive surgery were also investigated using statistical analysis. RESULTS: The incidence of posterior capsulotomy was 13.9% (39 of 280 eyes) and statistically significant differences were not observed based on age (7.7% in the 20's group, 13.8% in the 30's group and 14.4% in the 40's group, p=0.595). We divided subjects into 3 different groups based on axial length, below 22 mm, 22 to 26 mm and over 26 mm; posterior capsulotomy was performed in 0% (0/2), 7.2% (12/166) and 24.1% (27/112) of the patients, respectively, showing the longer axial length resulted in statistically significant increase in the incidence of posterior capsulotomy (p=0.036). The incidence of posterior capsulotomy was higher in females than in males (p=0.006). Correlations among posterior capsulotomy and type of cataract, type of IOLs and existence of diabetes mellitus, history of ocular trauma, atopic dermatitis and refractive surgery were not statistically significant. CONCLUSIONS: The difference in the incidence of Nd:YAG laser posterior capsulotomy according to age was not statistically significant in adult cataract patients under 50 years of age. We showed that longer axial length resulted in higher risk of posterior capsulotomy.

Nd:YAG Laser Posterior Capsulotomy and Visual Outcome.

Background: Neodymium-doped yttrium aluminum garnet (Nd:YAG) laser capsulotomy is a relatively noninvasive procedure that is used in the treatment of posterior capsular opacification (PCO). PCO is caused by proliferation of lens epithelial cells which causes fibrotic changes and wrinkling of the posterior capsule and results in decreased vision, glare, and other symptoms similar to that of the original cataract. Objective: To find out the visual outcome after performing Nd:YAG laser capsulotomy for PCO. Materials and method: A prospective clinical trial was carried out in National Institute of Ophthalmology (NIO), Dhaka, Bangladesh from January 2010 to June 2011 on purposively selected 70 adult subjects of both sexes who developed PCO within 2 months to more than 2 years after extracapsular cataract extraction with posterior chamber intra ocular lens implant. After thorough pre laser assessment Nd:YAG laser capsulotomy was carried out with Zeis VISULAS YAG II through Zeiss slit lamp under topical anesthesia. Data were recorded and expressed as proportion. Results: Out of the 70 subjects 40 were male and 30 were female. The average time interval of cataract surgery and Nd: YAG laser capsulotomy was 23 months. Capsular fibrosis (57.04%) was the predominant type of PCO. The pre laser visual acuity (VA) of more than 61.06% of eyes was 6/36 or below while 41.12% had VA hand movements to finger count. After Nd:YAG laser capsulotomy VA of 6/18 or better was achieved in 63.9% of eyes while 9.94% recovered to 6/9 and 11.36% achieved 6/6. None of these eyes showed further deterioration in VA. Conclusion: Nd:YAG laser capsulotomy for PCO is safe, effective and a rewarding procedure for improvement of vision.

Frequency and distribution of various posterior capsular opacities post cataract extraction / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To evaluate the frequency and distribution of various types of post cataract surgery and intraocular lens (IOL) implantation posterior capsular opacity (PCO) in hospitals.METHODS: This cross sectional, observational and descriptive study included 200 patients, 123 male and 77 female aged between 43 and 77(mean age 62.4) years, referring for cataract procedure from 2003 till 2007. The mean follow-up period of patients was 23 (range from 16 to 60) months. Data were gathered during follow-up time via a questionnaire and entered in a computer using SPSS software. Analysis was performed using ANOVA and Chi-Square tests. RESULTS: The various types of PCO included, fibrotic (63%), residual epithelial proliferative cells (15%) and mixed type (22%). The mean time period for development of postoperative decreased visual acuity due to PCO was 19.3(range from 3 to 48) months, younger patients had a significantly better vision post cataract surgery (P=0.0001), but the incidence of PCO was also more in them. In the older age group, fibrotic PCO was significantly more, while mixed type of opacities were the least prevalent (P=0.016). CONCLUSION: The present study did not determine any specific risk factors for development of PCO, and the most common type was fibrosis, all of the cases experienced both qualitative and quantitative decrease in vision and some of them required treatment with YAG Laser capsulotomy which is relatively expensive and has its own complications.

The Effect of Nd: YAG Laser Capsulotomy for Posterior Capsular Opacity after PC-IOL Implantation in Children

PURPOSE: To evaluate the effect of Nd: YAG laser capsulotomy for posterior capsular opacification (PCO) after posterior chamber intraocular lens (PC-IOL) implantation in children. METHODS: Thirty eyes of 23 children underwent Nd: YAG laser capsulotomy for PCO after PC-IOL implantation. The frequency of laser capsulotomy, elapsed time between cataract surgery and capsulotomy, laser parameters, pre and postoperative visual acuity, complications and recurrence were reviewed. RESULTS: From 108 eyes with intact posterior capsule after lensectomy, 30 (27.8%) were treated with Nd: YAG laser capsulotomy. The mean age at Nd: YAG laser capsulotomy was 7 years, the mean follow-up was 27 months, and the time interval between cataract operation and Nd: YAG laser capsulotomy was 13 months. Visual acuities of 20/40 or better were attained in 73% of eyes and visual acuities of 20/60 or less in 10% of eyes. PCO recurred in 12 eyes (40%), 10 of which were treated by performing a second laser capsulotomy, but the other two required a third laser capsulotomy. There was no relationship between the recurrence and the delay to initial laser capsulotomy, the amount of energy used for laser capsulotomy, or the patient age. One eye (3%) had corneal erosion, a bleeding from the pupillary margin and increased IOP; however, all responded well to medical treatment. CONCLUSIONS: Nd: YAG laser capsulotomy for PCO after PCL implantation in children offers a noninvasive and safe capability to create a clear visual axis. Although considered effective, there is a high likelihood that Nd: YAG laser capsulotomy will require revision.

Posterior Capsular Opacification and Nd: YAG Laser Capsulotomy in 811B, SI40NB, MA60BM Intraocular Lens

PURPOSE: To compare the incidence and the interval between the development of posterior capsular opacification (PCO) and Nd: YAG laser capsulotomy among patients implanted with a 811B, SI40NB, and MA60BM intraocular lens METHODS: One hundred ninty eyes of 157 patients who had undergone implant surgery with 811B, SI40NB, and MA60BM intraocular lens at the Presbyterian Medical Center were studied retrospectively. We compared the postoperative best corrected visual acuity, the incidence and the time interval between the development of PCO and laser capsulotomy, and the total energy used in laser capsulotomy among three intraocular lens groups. RESULTS: The incidence of development of PCO was 26.9% in 811B, 23.8% in SI40NB, and 10% in MA60BM groups, showing that incidence was significantly lower in the MA60BM group as compared to 811B (P=0.0016) or SI40NB (P=0.0056) group. The 811B group induced PCO earlier than SI40NB group. The energy used in Nd: YAG laser capsulotomy was lower in 811B than that in SI40NB or MA60BM. CONCLUSIONS: The incidence of posterior capsular opacification and that of Nd: YAG laser capsulotomy were found to be significantly lower in the MA60BM group than those in 811B or SI40NB group.