Visual outcome and complications after ND-YAG laser capsulotomy in patients with posterior capsular opacification

Cataract remains the most common treatable cause of blindness in the developing world including Pakistan. Posterior capsular Opacification is a natural consequence of extra capsular cataract extraction and phacoemulsification. To see complications during and after Nd-YAG laser capsulotomy and evaluate the visual outcome in aphakic and pseudophakic patients with posterior capsular Opacification. The study was conducted on consecutive aphakic and pseudophakic patients suffering from posterior capsular Opacification who were admitted for Nd-YAG laser capsulotomy at Ophthalmology Department of Saidu Teaching Hospital, Saidu Sharif, Swat, from November 2006 to May 2007. Out of 45 cases, 28 [62.2%] were males and 17 [37.8%] females. The mean age was 56 years and the mean time interval between cataract surgery and Nd-YAG capsulotomy was 31.2 months. Fifty eyes of 45 patients with posterior capsular Opacification underwent Nd-YAG laser capsulotomy, of which 27 [54%] were right and 23[46%] were left sided. Twenty nine [58%] eyes had capsular fibrosis, 14[28%] had Elschnig pearls, 6[12%] had both capsular fibrosis and Elschnig pearls and one [2%] eye had capsular wrinkling. Damage to intraocular lens in two eyes and corneal bum in one eye were procedural complications. Post-laser complications were raised intraocular pressure in 7 eyes, corneal oedema and anterior uveitis in two eyes each. Twenty five [50%] eyes had visual acuity of 6/60 or less before capsulotomy. The visual acuity after Nd-YAG laser capsulotomy was 6/60 or less in 15[30%] eyes. Four [8%] eyes had good pre-laser visual acuity of 6/6-6/12; while 14[28%] eyes had post laser visual acuity of 6/6-6/12. No case had further deterioration of visual acuity after Nd-YAG laser capsulotomy. Capsular fibrosis is the commonest presentation of posterior capsular Opacification. Damage to intraocular lens and corneal burn were encountered during procedure. Majority of patients had significant improvement in visual acuity. Raised intraocular pressure, corneal oedema and iritis were seen as post laser complications