The influence of size and shape of Nd:YAG capsulotomy on visual acuity and refraction.

Servet Cetinkaya,Halil Ibrahim Yener,Muammer Ozcimen,Nursen Oncel Acir,Zeynep Dadaci,Yasemin Fatma Cetinkaya

doi:10.5935/0004-2749.20150057

Abstract

To evaluate the influence of size and shape of neodymium:yttrium aluminum- Garnet (Nd:YAG) laser capsulotomy on visual acuity and refraction. We retrospectively evaluated 85 eyes of 67 patients treated with Nd:YAG laser posterior capsulotomy for posterior capsule opacification (PCO). The mean age of included patients was 57.57 ± 9.26 (mean ± standard deviation, 38-75 years). The mean interval between surgery and Nd:YAG laser capsulotomy was 26.09 ± 7.08 (10-38) months. Patients were divided into four groups according to the shape and size of capsulotomy. Groups comprised patients with cruciate shape capsulotomies with openings of less than or equal to 3.5 mm (Group 1) or greater (Group 2) and patients with circular shape capsulotomies with openings of less than or equal to 3.5 mm (Group 3) or greater (Group 4). The mean number and energy of laser firings were significantly higher in Group 4 (p=0.00), and significantly lower in Group 1 (p=0.00), compared with that in other groups. Pre-procedural and post-procedural mean spherical equivalent (SE) values were significantly higher in Group 1 (p=0.026 and p=0.011, respectively). No statistical difference in best-corrected visual acuities (BCVA) or intraocular pressures (IOP) were observed between groups before (p=0.44 and p=0.452, respectively) or after capsulotomy (p=0.108 and p=0.125, respectively). A significantly higher number of patients in Group 4 (p=0.001), and a significantly lower number of patients in Group 1 (p=0.001), reported floating bodies compared with that in other groups. No significant changes in SE or intraocular pressure were observed after capsulotomy in any group (p=0.074 and p=0.856, respectively). Best-corrected visual acuity was significantly improved following capsulotomy in all groups (p<0.01). Cruciate shape capsulotomy with an opening of 3.5 mm or less provides the greatest improvement in visual function with minimal complications.

Highlights

Posterior capsule opacification is the most common complication of cataract surgery and results from the proliferation and migration of residual lenticular epithelial cells[1,2,3]
O grupo 1 incluiu pacientes com forma cruzada e tamanho igual ou menor do que 3,5 mm de abertura capsulotomia, Grupo 2, forma cruzada e tamanho maior do que 3,5 mm, Grupo 3, forma circular e tamanho igual ou menor do que 3,5 mm e Grupo 4, forma circular e tamanho superior a 3,5 mm
We evaluated the effect of neodymium:yttrium alu minum-Garnet (Nd):YAG capsulotomy size and shape on visual outcomes

Summary

Introduction

Posterior capsule opacification is the most common complication of cataract surgery and results from the proliferation and migration of residual lenticular epithelial cells[1,2,3]. Opacification may be dim inished by atraumatic surgery, complete cleaning of cortex residues, polishing of both anterior and posterior capsules, or the use of specific intraocular lens (IOL) designs[1,4]. Nd:YAG laser capsulotomy has utility in the treatment of PCO; a number of complications of this procedure have been reported including IOL dislocation leading to hyperopia, IOL subluxation or luxation, IOP elevation, cystoid macular edema, and retinal detachment[11,12,13]. A number of Nd:YAG laser capsulotomy shapes and sizes may be utilized. We evaluated the effect of Nd:YAG capsulotomy size and shape on visual outcomes

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Results

Discussion

Conclusion