A Comparative Study of Visual Outcome and IOP Changes in Postoperative PCO Cases Among Diabetics and Non Diabetics Following Nd: YAG Laser Capsulotomy

Abstract

Background: Posterior capsular opacification is the most common long term complication of modern IOL surgery.ND: YAGlaserre mains the corner stone of its treatment. In this study, an attempt is made to study the visualoutcome and change in the intraocular pressure following Nd: YAG laser capsulotomy and compare the resultsbetween diabetic patients and non-diabetic patients.Method: This was a prospective study of 100 patients (50 diabetics and 50 nondiabetics), conducted in KhajaBanda Nawaz Teaching and General Hospital, Kalaburgai. All patients in the age group 45-75 years, attendingthe regular OPD who presented with visually significant posterior capsular opacification and were treated withNd:YAG laser capsulotomy. Patients were included in the study taking into consideration inclusion and exclusioncriterias. Patients were followed up on first day, first week and the four weeks and the improvement in the BCVAand the changein IOP (Intra Ocular pressure) were recorded.Results: All the patients treated for PCO with Nd:YAG laser capsulotomy showed an improvement in visualacuity. The visual outcome at four weeks (41%had > 6/12) was found to be better than that at first week (34 % hadthe same) and first day (16% had the same). The final visualoutcome at 4 weeks was found to be better in nondiabetics(52% had>6/12) compared to diabetics (30% had>6/12). All the patients showed an increase in IOP atthe first day and first week of follow up and return to near normal of baseline values at four weeks of follow up,the pattern of change in IOP being similar in both the study groups.Conclusion: Nd:YAG laser capsule to May effectively improves the visualacuity inpatients with visually significantPCO. The comparatively poor outcome in the diabetic group can be attributed to the associated retinopathychanges. Nd:YAGl aser capsulotomy is associated with a transient rise in the intraocular pressure in all patientswhich can very rarely remain persistently high.