Effect of posterior capsular opacification and Nd: YAG laser capsulotomy on the shifiting of 1CU accommodative intraocular lens

Abstract

Background Posterior capsular opacification (PCO)affects the pseudoaccommodation of 1CU accommodative intraocular lens (1CU AIOL).At present,few studies on the effect of PCO and Nd∶ YAG laser capsulotomy on intraocular shifting of 1CU AIOL are published.Objective The present study was to evaluate the effect of PCO and Nd∶YAG laser capsulotomy on the shifting of 1CU AIOL.Methods A respective serial caseobservational study was designed.Written informed consent was obtained from each patient prior to this study.Twentyfour eyes of 20 patients with PCO after phacoemulsification and implantation of 1CU AIOL were included in this study.Ocular examination was performed 3 months after IOL implantation,1 day before Nd:YAG laser capsulotomy and 3 months after Nd∶YAG laser capsulotomy to evaluate the distance corrected near visual acuity(DCNVA).The difference in the anterior chamber depths before and after administering 1％ pilocarpine topical eye drops was measured with the IOLMaster to determine the intraocular shifts of the IOL.The extent of IOL shifting was compared among 3 time points to assess the factors influencing IOL accommodation after 1CU AIOL implantation.Results The shifting amplitude of 1CU AIOL was(0.44±0.21)mm 3 months after implantation of 1CU AIOL,(0.27±0.11)mm 1 day before Nd ∶ YAG laser capsulotomy,and (0.34±0.10) mm 3 months after Nd ∶ YAG laser capsulotomy,showing a significant difference among them(F=7.180,P=0.001).The shifting amplitude of 1CU AIOL significantly declined 1 day before Nd∶YAG laser capsulotomy in comparison with 3 months after implantation of 1 CU AIOL(P =0.006).The shifting amplitude 3 months after Nd∶YAG laser capsulotomy increased slightly in comparison with 1 day before Nd∶YAG laser capsulotomy(P=0.059).DCNVA was(3.1±0.9)J 3 months after implantation of 1CU AIOL,(6.2±0.8) J 1 day before Nd ∶ YAG laser capsulotomy and(3.4±0.7) J 3 months after Nd ∶ YAG laser capsulotomy,with a significant difference among them (F =110.270,P =0.000).DCNVA was lower 1 day before Nd∶ YAG laser capsulotomy than 3 months after implantation of 1CU AIOL(P＜0.05).However,DCNVA was higher 3 months after Nd∶YAG laser capsulotomy than that of 1 day before Nd∶YAG laser capsulotomy (P＜0.05).There was no significant correlations between DCNVA and IOL movement 3 months after IOL implantation,1 day before Nd∶ YAG laser capsulotomy and 3 months after Nd ∶ YAG laser capsulotomy (r1 =-0.150,P1 =0.486,r2 =-0.320,P2 =0.122,r3 =-0.100,P3 =0.633).Conclusions The shifting amplitude of 1CU AIOL markedly declines due to PCO.No clinically significant influence of Nd ∶ YAG laser capsulotomy on the shifting amplitude of 1 CU AIOL is found.DCNVA can improve after Nd∶YAG laser capsulotomy.Multiple inter-related factors concerning pseudophakic accommodation may influence DCNVA. Key words: Posterior capsular opacification; Accommodating intraocular lens; Nd∶ YAG laser; Capsulotomy