Short-Term Anterior Segment Changes After Nd-YAG Laser Posterior Capsulotomy in Pseudophakic Eyes with Fuchs' Endothelial Dystrophy.

Abstract

PurposeTo describe the changes in the central corneal thickness (CCT), endothelial cell count (ECC), intraocular lens (IOL) position, and refractive error 1 and 3 months after Nd-YAG laser posterior capsulotomy (YAG-PC) for posterior capsular opacification (PCO) in pseudophakic eyes with Fuchs’ endothelial cell dystrophy (FECD).DesignProspective case-control.ParticipantsFifty pseudophakic eyes of 50 patients with visually significant PCO (25 with healthy corneas, and 25 with FECD grade 1 and 2).MethodsFECD was clinically graded, and only patients without clinically evident corneal edema were included in the study (grade 1 and 2). All patients received YAG-PC and were followed up after 1 and 3 months. Best-corrected visual acuity, refractive errors, ACD, CCT, and ECC were assessed and compared between the pre-laser values and that of the 2 follow-up visits.ResultsIn both groups, BCVA showed significant improvement (P<0.05). Compared to healthy controls, a significant hyperopic shift was observed in the FECD eyes at the 2 follow-up visits (P=0.027, and 0.019). A significant backward movement of the IOL was observed in the FECD eyes in the 2 follow-up visits (P=0.043, and 0.02). There was a significant correlation between the hyperopic shift in the FECD eyes and the ACD deepening during the 1st month (R= −0.6, P=0.001) and 3rd month (R= −0.4, P=0.04). Significant drop in the ECC was noted in both groups but without significant increase in the CCT.ConclusionCompared to controls, a hyperopic shift and backward movement of the IOL were observed in the FECD eyes after YAG-PC. No significant corneal thickening was found in both groups despite the significant drop in the ECC. Future studies are required to confirm our results and monitor the long-term changes after YAG-PC in FECD.