Should We Expect the Rise of Nd:YAG Laser Capsulotomies in the Future?

Abstract

Posterior capsular opacification (PCO) manifested by the proliferation and migration of lens epithelial cells (LECs) and intraocular straylight may impair visual function and quality of life of patients, even with good postoperative visual acuities. 1 van Bree M.C. van den Berg T.J. Zijlmans B.L. Posterior capsule opacification severity, assessed with straylight measurement, as main indicator of early visual function deterioration. Ophthalmology. 2013; 120: 20-33 Abstract Full Text Full Text PDF PubMed Scopus (33) Google Scholar ,2 Yotsukura E. Torii H. Saiki M. Negishi K. Tsubota K. Effect of neodymium:YAG laser capsulotomy on visual function in patients with posterior capsule opacification and good visual acuity. J Cataract Refract Surg. 2016; 42: 399-404 Abstract Full Text Full Text PDF PubMed Scopus (19) Google Scholar Although PCO can be easily treated with neodymium-doped yttrium aluminum garnet (Nd:YAG) laser capsulotomy, the procedure is associated with health care costs, treatment burden, and rare adverse events. 3 Aaronson A. Grzybowski A. Tuuminen R. The health economic impact of posterior capsule opacification in Finland comparing the two single-piece intraocular lenses: a cost-consequence analysis. Acta Ophthalmol. 2019; 97: e1152-e1153 Crossref PubMed Scopus (9) Google Scholar Optimization of intraocular lens (IOL) design and materials has substantially decreased the rates of Nd:YAG treatment. 4 Apple D.J. Peng Q. Visessook N. Werner L. Pandey S.K. Escobar-Gomez M. Ram J. Auffarth G.U. Eradication of posterior capsule opacification: documentation of a marked decrease in Nd:YAG laser posterior capsulotomy rates noted in an analysis of 5416 pseudophakic human eyes obtained postmortem. Ophthalmology. 2020; 127: S29-S42 Abstract Full Text PDF PubMed Scopus (7) Google Scholar ,5 Lindholm J.-M. Laine I. Tuuminen R. Five-year cumulative incidence and risk factors of Nd:YAG capsulotomy in 10 044 hydrophobic acrylic 1-piece and 3-piece intraocular lenses. Am J Ophthalmol. 2019; 200: 218-223 Abstract Full Text Full Text PDF PubMed Scopus (19) Google Scholar Specifically, the sharp optic edge of the IOL and a firm capsular-IOL adhesion forming a “barrier effect” is emphasized to inhibit LEC migration and PCO. Comparison of Nd:YAG Laser Capsulotomy Rates Between Refractive Segmented Multifocal and Multifocal Toric Intraocular LensesAmerican Journal of OphthalmologyVol. 222PreviewTo investigate the early incidence of neodymium-doped yttrium aluminum garnet (Nd:YAG) laser capsulotomy according to intraocular lens (IOL) type (nontoric vs toric) and surgical techniques (femtosecond laser–assisted cataract surgery vs conventional phacoemulsification) in eyes with refractive multifocal IOLs. Full-Text PDF