Influence of the shape of Nd:YAG capsulotomy on visual acuity and refraction

Abstract

Background Posterior capsule opacification (PCO) is a common complication after cataract surgery. The need for PCO prevention becomes increasingly important. During the past decades, various forms of prevention have been examined, including general measures during surgery, pharmacological prevention, and by interfering with the biological processes of epithelial mesenchymal transformation (EMT) in lining epithelial cells (LECs). The first-line treatment option is posterior capsulotomy performed with a neodymium:yttrium–aluminum–garnet (Nd:YAG) laser. To evaluate the influence of the size and shape of Nd:YAG laser capsulotomy on visual acuity and refraction. Patients and methods We evaluated 20 eyes of 20 patients treated with Nd:YAG laser posterior capsulotomy for PCO. Patients were divided into two groups according to the shape of capsulotomy: patients with cruciate shape capsulotomies with openings of more than 3 mm (group 1) and patients with circular shape capsulotomies of more than 3 mm. Results The mean number and energy of laser firings were significantly higher in group 2 and significantly lower in group 1 (P=0.011). In the preprocedural spherical equivalent, there was no statistical significance between the two groups (P=0.971). In the postprocedural spherical equivalent also there was no statistical significance between the two groups (P=0.643). Significant change in intraocular pressure following capsulotomy was observed in group 2 (P=0.011), but there was no significant change in group 1. A higher number of patients in group 2 and a lower number of patients in group 1 report floating bodies after YAG laser capsulotomy (P≤0.050 significant). Regarding floating bodies there was statistical significance between the two groups (P=0.025). Best-corrected visual acuity highly significantly improved following capsulotomy in both the groups (P≤0.001). Conclusion Cruciate shape capsulotomy provides improvement in visual function with minimal complications.