Refractive stability of low-cost intraocular lens following Nd:YAG capsulotomy

Abstract

Introduction Low-cost intraocular lenses (IOLs) have been used in developing countries for many years. In a recent randomized trial, they were found comparable to high-end IOLs in terms of safety, visual outcomes, and posterior capsule opacification (PCO) formation. Our team observed occasional significant refractive changes following Nd:YAG capsulotomy for patients implanted with these IOLs. We aimed to assess the changes in refraction and the anterior chamber (AC) depth induced by Nd:YAG capsulotomy for PCO following implantation of a low-cost IOL. Patients and methods This prospective study was conducted on a cohort of sequential patients with PCO following uncomplicated phacoemulsification and implant of in-the-bag low-cost IOL. Changes in refraction (spherical equivalence, cylinder power, and cylinder axis) were assessed by means of subjective verification of autorefraction. Changes in AC depth were assessed by means of ultrasound biomicroscopy. Changes in cylinder power and axis were included to assess IOL tilt. Results A total of 50 consecutive eyes were enrolled. However, five eyes of three patients were lost to follow-up. A total of 45 eyes of 36 patients completed the pre-YAG and post-YAG assessments. An overall 66.7% of patients were female. An overall 25% had bilateral capsulotomy. The mean age at capsulotomy was 62.4±7.46 years. The mean duration since cataract extraction was 13.3±17.15 months. The mean IOL power was 20.4±2.43 D. No significant changes were found in spherical equivalence, axis of cylinder, and AC depth. However, a significant change in the cylinder power (mean change: 0.36±0.93 D, P =0.039) was observed. Conclusion Our study adds further confirmation on low-cost IOLs being a suitable alternative to high-end IOLs in developing countries and in outreach settings.