Factors Affecting IOP Changes Following Neodymium: Yttrium Aluminum GARNET (Nd:YAG) Capsulotomy

ABSTRACT

Introduction: Transient intraocular pressure rise is acommonly observed phenomenon following NdYAGcapsulotomy. However, IOP change is considered to bedependent on multiple factors. Study aimed to assess factorsdetermining the IOP change following NdYAG capsulotomy.Material and Methods:A total of 150 adult patients, scheduledto undergo NdYAG laser capsulotomy for management ofposterior chamber opacification (PCO) were enrolled. Age,gender, time since cataract surgery, PCO grade, IOP, topicalhypotensive use was noted in all the cases. Amount of energyused in NdYAG procedure was recorded. Postoperative IOPchange was noted immediately, 1 hr and 3 hr postoperativeintervals. Rise >5 mm was considered clinically significant.Independent samples ‘t’-test, Chi-square test and binarylogistic regression were used. Data analysis was performedusing SPSS 15.0 software.Results: Mean age of patients was 60±11.3 years. Majoritywere females (59.3%). Majority of patients had Grade I andII of PCO (64%), 5-10 years duration since cataract surgery(79.3%) and topical hypotensive use was done(58%).Preoperative mean IOP was 15.99±2.72 mmHg. Energyused was 55.7±52.7 mJ. A total of 19 (12.7%) patients hadIOP rise >5 mm. On univariate analysis, Grade III or abovePCO, higher level of total energy use and low hypotensive usewere found to be significantly associated with IOP rise. Onmultivariate assessment, low hypotensive use and high energyuse were found to be significantly associated with clinicallysignificant IOP rise (p<0.05).Conclusions: Low energy and prophylactic topicalhypotensives were protective against IOP rise.