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.

Hysteroscopic treatment of septate uterus with Neodymium: YAG laser / 中国微创外科杂志

Objective To investigate the clinical effect of hysteroscopic treatment of septate uterus with Neodymium: YAG laser. Methods Forty-six sterile patients with septate uterus received hysteroscopic metroplasty with Nd: YAG laser.The metroplasty was completed under the guidance of B-ultrasonography in 41 patients with incomplete septate uterus,and with the assistance of laparoscopy in other 5 patients with complete septate uterus.Results The metroplasty was successfully conducted on one session in 45 patients,the success rate being 98%(45/46).Postoperative follow-up examinations in 28 patients found pregnancy within 1 year in 20 patients,16 of whom delivered of a viable term infant,the pregnancy rate within 1 year being 71%.Conclusions Hysteroscopic treatment of septate uterus with Nd: YAG laser is effective.The uterine neck may not be excessively dilated,the intraoperative bleeding can be thoroughly controlled,and the procedure under general anesthesia is relatively safe.

Management of Vitreous Floaters with Neodymium-YAG Laser

After Neodynium(Nd)-YAG laser photodisruption for vitreous floaters which were annoying the central visual field in 28 patients(28 eyes), we evaluated the efficacy of the procedure and the satisfaction degree of patients. Vitreous floaters were not recognized in 46 percents(13 eyes) of the patients, stayed away from the central visual field in 32 percents of the patients(9 eyes). Broken opacities were moved to retina in 22 percents(6 eyes) after treatment. In satisfaction degree of patients, 64 percents of the patients(18 eyes) were completely satisfied, 25 percents of them(7 eyes) were fairly satisfied, and 11 percents of them(3 eyes) were not satisfied at all. Complaints of unsatisfied patients were persisting floaters in 5 eyes, increased number of the floaters in 3 eyes and central visual field disturbance in 2 eyes. The responsible factors for failure in treatment were the size of the floaters larger than 2/3 disc diameter(DD), their locations closer than 2DD from retinal surface and their peripheral locations. Complications included the fragment shifting to posterior central zone in 2 eyes and the chorioretinal damage in 2 eyes. Our results suggest that Nd-YAG laser photodisruption seems to be useful on the discrete vitreous floaters less than 1/3DD in size and apart from retinal surface more than 2DD.

The Effect of the Nd:YAG Laser on the Rabbit Retina

The effect of the Nd:YAG laser on the rabbit retina was evaluated with fundus photography, light microscopy and transmission electron microscopy(TEM), and compared with the effect of the Argon laser. Fundus photography was performed at 2 days, 4 days, 7 days, 14 days, 29 days and 49 days after treatment. The enucleated retina was examined by light microscopy and TEM. In YAG treated eye, laser reaction was not found at 0.5mJ level but laser reaction(G2-3) was found at 1.5mJ level. Laser reaction(G3-4) with expulsive bleeding was found at 2.5 and 3.5mJ level. Bleeding was seemed to be originated from the choroidal layer. 2 days after treatment, hemorrhage was sustained but bleeding was not continued. 7 days after treatment, hemorrhage was completely absorbed. In Argon treated eye, photocoagulation burns was well formed without and bleeding. In pathologic examination of YAG treated eye, full thickness disruption of the retina amd Bruch's membrane and replacement of these layers with fibrous scar tissue were revealed at 2.5 and 3.5mJ level. In 1.5mJ energy level of the YAG laser and Argon laser irradiation, the outer half of the retina, RPE and Bruch's membrane appeared to be pridominantely affected than the inner half of the retina. The extent and character of his to pathology in Argon treated lesion was not so different from that of the YAG laser 1.5mJ lesion.

Lysis of vitreous strands with neodymium: YAG laser

Eighteen eyes with vitreous strands adherent to the corneoscleral wounds of previous cataract surgery were treated with neodymium: YAG laser to lyse those strands. Twelve eyes were treated for management of cystoid macular edema (CME group); six eyes were treated for prophylaxis of possible CME (prophylactic group). In the CME group, visual acuity improved two or more lines in nine eyes (75.0%), and seven eyes had a post laser visual acuity of 0.5 or better (One eye had a pre-treatment visual acuity of 0.5 or better). In the prophylactic group, visual acuity was either maintained at the pre-treatment visual acuity of 0.5 or better. In the prophylactic group, visual acuity was either maintained at the pre-treatment level or improved in five eyes (83.3%) 18 months later following laser treatment. This procedure was complicated by retinal detachment in one case and the elevation of intraocular pressure over 10 mmHg in another case.

An Experimental Study on Renal Tissue Damage of Rabbit According to Neodymium-YAG Laser Energy / 대한비뇨기과학회지

Neodymium YAG (Nd-YAG) laser is a new instrument for the treatment of various urologic disorders where coagulation is necessary but still limited in cases. It avoids many of the side effects of electrocoagulations. Nd.YAG Iaser is a safe and effective modality, reducing blood loss, shortening operation time and preserving functional integrity on remaining renal tissue. In this experiment, to investigate the Nd-YAG Laser effect to renal tissue and the adaptation to renal surgery were aimed. We made the experimental study on renal tissue damage according to the change of irradiation time and power of NJ-YAG laser. The following results were obtained; After irradiation of Nd-YAG laser, renal tissue damage was noted on 30 Watt, 3 seconds and 5O Watt, 1 second, and the degree of renal tissue damage was increased with in creasing of laser power and time. A 2mm depth injured renal tissue was noted on 150-250 Joules, which coagulates the vessel with several mm diameter. Judging from the results of this experiment it may be believed that Nd-YAG laser can be adaptable to renal surgery in bleeding control without severe renal tissue damage.