Laser Posterior Capsulotomy Research Articles

Effect of Nd:YAG laser posterior capsulotomy on higher order aberrations in different types of posterior capsule opacification: A prospective study.

To evaluate higher order aberrations (HOA) in different types of posterior capsule opacification (PCO) and analyze its changes fosllowing Nd:YAG laser posterior capsulotomy (LPC). Tertiary care ophthalmic hospital. Prospective, comparative, observational study. One hundred ninety-three pseudophakic eyes with PCO were evaluated over 3 months. PCO was classified into pearly, fibrous, and mixed types. Their uncorrected visual acuity (UCVA), corrected distance visual acuity (CDVA), intraocular pressure (IOP), evaluation of posterior capsule opacification (EPCO) scoring and root mean square values of HOA (total, coma, spherical, and trefoil) were measured using a wavefront aberrometer before and after LPC. Pearly, fibrous, and mixed PCO were observed in 89 (46.1%), 47 (24.4%), and 57 (29.5%) eyes respectively. The UCVA and CDVA showed improvement in all types of PCO post-procedure. The total HOA was 0.48 ± 0.47, 0.43 ± 0.42, 0.37 ± 0.34, and 0.76 ± 0.53, the coma aberrations were 0.18 ± 0.15, 0.18 ± 0.14, and 0.19 ± 0.19, spherical aberrations were 0.07 ± 0.12, 0.09 ± 0.12, and 0.05 ± 0.06, whereas the trefoil aberrations were 0.35 ± 0.44, 0.24 ± 0.26, and 0.21 ± 0.20, 15-day post-Nd:YAG LPC in pearly, fibrous, and mixed PCO respectively, all of which showed a significant reduction. The EPCO score showed no significant difference between different subtypes of PCO and had no correlation with the HOA. Post Nd:YAG LPC showed improvement in visual acuity with significant reduction in HOA in all types of PCO.

A Study of the Impact of ND: Yag Laser Posterior Capsulotomy on Foveal Thickness and Central Corneal Thickness by Using Spectral Domain Optical Coherence Tomography

A Study of the Impact of ND: Yag Laser Posterior Capsulotomy on Foveal Thickness and Central Corneal Thickness by Using Spectral Domain Optical Coherence Tomography

Application of objective optical quality analysis system in guiding early posterior capsule opacification laser treatment: An observational study.

In the present study, we aimed to demonstrate the objective guiding role of objective scatter index (OSI) in patients with early stage posterior capsule opacification (PCO), especially in patients with multifocal intraocular lens (IOL) implantation. A prospective randomized case analysis was conducted on elderly patients experiencing PCO, exhibiting best-corrected visual acuity (BCVA) below 0.2 LogMAR. Exclusion criteria comprised patients with diabetes, glaucoma, high myopia, trauma, endothelial dystrophy, maculopathy or prior eye surgery affecting visual acuity. The main observational indicators were patient gender, age, post-cataract surgery duration, BCVA (LogMAR), and OSI values. For patients undergoing laser posterior capsulotomy, meticulous documentation of pre-laser OSI values and post-laser OSI values was undertaken. Subjective visual quality was then compared using the Chinese version visual function index-14 (VF-14-CN). The study comprised 65 eyes from 56 patients. PCO developed, on average, 2.06 ± 0.94 years (ranging from 0.5 to 4 years) after the initial surgery, with the OSI consistently exceeding 3.0. Among these cases, only 40 eyes underwent laser posterior capsulotomy using Nd:YAG laser, including 26 eyes implanted with monofocal IOLs and 14 eyes implanted with multifocal IOLs. Following laser posterior capsulotomy for early-stage secondary cataracts, there was a significant decrease in OSI values compared to the presurgery state, coupled with a notable increase in VF-14-CN scores. Among the 14 cases with multifocal IOL implantation, pre-laser VF-14-CN scores were lower compared to those with monofocal IOLs. Post-laser posterior capsulotomy, patients reported a marked improvement in self-perceived symptoms. The OQAS functioned as an objective assessment metric for the laser treatment of early stage PCO. In cases involving multifocal IOL implantation, the visual disturbance caused by PCO was more pronounced, underscoring the significance of OSI as a valuable guide for laser treatment in these patients.

A clinical study of the neodymium-doped yttrium–aluminium–garnet laser posterior capsulotomy: Visual outcome and early complications

Objectives: The objectives of this study were as follows: To study the efficacy of neodymium-doped yttrium–aluminium–garnet (Nd:YAG) laser capsulotomy in posterior capsular opacification (PCO) by analysing the visual outcome. To study any other early complications seen following Nd:YAG laser capsulotomy. Materials and Methods: A prospective interventional study was done in the Department of Ophthalmology of a tertiary care hospital in the Marathwada region of Maharashtra. A total of 55 eyes developing PCO after cataract surgery were included in the study from November 2022 to October 2023. Routine pre-laser evaluation using slit-lamp biomicroscopy, intraocular pressure (IOP) measurements and dilated fundus examination was done. Thirty-eight patients had undergone manual small incision cataract surgery with polymethyl methacrylate intraocular lens (IOL) implantation and 17 patients had undergone phacoemulsification surgery with acrylic foldable IOL implantation. The patient was then followed up on Days 2, 7, 30, and 3 months to look for any early post-laser complications. Results: A total of 55 eyes were included in the study. The age group of patients included in the study is from 50 to 75 years. Most of the patients 21 were in the age group of 56–60 years. Twenty (36%) were male and 35(63%) females; thus, female preponderance is seen. On retro-illumination of the slit lamp, 9 (16.3%) patients had severe PCO having vision ≤3/60, 24 (43.6%) patients had moderate PCO with vision 3/60–6/60 and 22 (40%) patients had mild PCO with vision 6/60–6/18. Forty-seven patients (85%) had visual acuity of more than 6/12 at the end of 3 months. In most patients, an appropriate central capsulotomy was achieved within the total energy of 60 mJ but in three cases more than 100 mJ energy was used due to the thick posterior capsule. About 6% of subjects showed increased IOP of more than 21 mm Hg but returned to normal level within 1 week. Mild uveal reaction in the form of anterior chamber flare and cells was seen in 2% of cases. IOL pitting was seen in 5 (8%) cases. One (2%) patient had a vision of 3/60 and a significant increase in macular thickness at day 7 post-laser which decreased at 1 month follow-up by appropriate treatment. No evidence of any retinal tears or retinal detachment seen. Conclusion: PCO is a common delayed complication seen after cataract surgery. This opacification decreases the vision of the patient to affect day-to-day activities. It can be easily managed on an outdoor basis by a non-invasive and effective Nd:YAG laser posterior capsulotomy procedure. This procedure has been shown to increase the visual outcome and has fewer complications which can be managed easily.

Neodymium-doped yttrium aluminum garnet (Nd: YAG) laser treatment in ophthalmology: a review of the most common procedures Capsulotomy and Iridotomy.

Nowadays, lasers are used in various medical fields. Ophthalmology was the first medical specialty to utilize lasers in patient treatment and still remains the leading medical field that uses laser energy for both therapeutic and diagnostic purposes. The neodymium: yttrium-aluminum-garnet (Nd: YAG) laser is one of the most common lasers used in ophthalmology. It is a solid-state laser with a wavelength of 1064nm that works on the principle of photodisruption. Since its introduction in ophthalmology over 40 years ago, it has found various applications, mainly for procedures where cutting or disruption of ocular tissue is required. Compared to surgical alternatives, the use of Nd: YAG lasers on ocular tissue is minimally invasive. In this review, we focus on the two most common ophthalmic applications of Nd: YAG laser - laser peripheral iridotomy and posterior capsulotomy. The history of the techniques, current trends, potential complications, and the prognosis for future use is discussed.

Visual axis reopacification after Nd:YAG laser posterior capsulotomy

Posterior capsular opacification (PCO) and anterior hyaloid face opacification are the two possible causes of visual axis opacification after cataract surgery, of which PCO is more common in adults. This is treated by neodymium-doped yttrium aluminum garnet (Nd:YAG) laser-assisted disruption of the opacified posterior capsule/membrane. Recurrence of visual axis opacification after a successful Nd:YAG laser posterior capsulotomy is infrequent. We report a case of visual axis reopacification after a successful Nd:YAG capsulotomy for PCO in an adult with no history of systemic or ocular disease who underwent phacoemulsification and an acrylic hydrophobic intraocular lens implantation. Patients should be explained about this possibility when undergoing Nd:YAG capsulotomy.

The Outcome of O-shape and Y-shape Nd:YAG Laser Capsulotomy in Patients with Posterior Capsule Opacification

Introduction & Objectives : Neodymium:yttrium-aluminium-garnet (Nd:YAG) laser capsulotomy is the method of choice in secondary cataract. Nd:YAG laser capsulotomy is a safe and effective method in treating decreased visual acuity. This study was conducted to determine the outcomes of Nd:YAG laser capsulotomy with O shape and Y shape in patients with posterior capsule opacification.
 Methods : This descriptive study was conducted in Siloam Karawaci General Hospital from February – March 2023. We included all patients with posterior capsule opacification who underwent Nd:YAG laser capsulotomy. The outcome included pre- and post-procedure uncorrected visual acuity (UCVA) after 1 week follow-up.
 Results : A total of six eyes from five patients (two men, three women) were included in this study. Three subjects underwent Nd:YAG laser with O-shape and three subjects with Y-shape. All subjects with O- shape had improved UCVA (0.7 to 1.0; 0.2 to 0.5; 0.5 to 0.8). Meanwhile, all subjects with Y-shape also had improved UCVA (0.2 to 0.5; 0.2 to 0.3; 0.5 to 0.7). No subjective symptoms reported following capsulotomy procedure in all patients.
 Conclusion : Nd:YAG laser posterior capsulotomy with O shape provided better UCVA than Y shape.

Secondary cataract in patients after traditional phacoemulsification in comparison with femtolaser extraction

BACKGROUND: Secondary cataract is a frequent complication of the postoperative period of cataract surgery.
 AIM: To evaluate the timing of secondary cataract formation in pseudophakic eyes after cataract extraction phacoemulsification, carried out as traditional phacoemulsification in comparison with femtolaser cataract surgery.
 MATERIALS AND METHODS: We conducted a retrospective study of patients who underwent YAG laser posterior capsulotomy (98 people, 108 eyes). All patients were divided into two groups. First group (54 people, 58 eyes) consisted of patients in whom secondary cataract occurred after traditional phacoemulsification. In the second group (44 people, 50 eyes) secondary cataract occurred after femtolaser-assisted cataract surgery. All patients were implanted with a monofocal intraocular lens MIOL-2.
 RESULTS: The data analysis revealed that the period of secondary cataract formation in the first group was 2.83 ± 1.25 years, in the second group 3.75 ± 1.0 years.
 CONCLUSIONS: The analysis showed that the secondary cataract after traditional phacoemulsification occurs earlier by an average of 1 year than after femtolaser-assisted cataract surgery.

Complications of Nd Yag Laser Capsulotomy

Introduction: Aim and objective is to study the intra and post laser complications of Nd yag laser posterior capsulotomy and to find out the incidence of complications. Materials and Methods: This study was conducted in the department of ophthalmology, Ad-Din Women Medical College 2, Bara moghbazar, Dhaka from July 2018 to June 2022. Our study included 206 patients of 220 eyes with significant PCO. Before laser capsulotomy all patients were assess by routine slit lamp examination, IOP measurement and posterior segment examination done for every patient for exclusion of gross posterior segment pathology. Nd yag laser capsulotomy was carried out under topical anesthesia. These patients were assessed for post laser visual acuity and complications in 1st POD after 7 day and 1 month. Every patients with post laser routine medications and as per need of other related eye problems. Result: Total 220 eyes of 208 patients included in our study ,including 93 male (44.71%) and 115 female (55.29%).Range of age were 21yrs to 87 years. Laser capsulotomy were done one eye in 208 patients and both eyes in 14 patients. Range of energy used in our study from 1 to 4.5 mJ. Complications were noted after yag laser capsulotomy In 29 eyes (13.76%) though after taking maximum precaution for avoiding complications including pre laser slit lamp examination, assessment of IOP, proper dilatation of pupil, power setting were minimum as per as possible. Conclusion: The Nd yag laser capsulotomy is an effective, safe procedure for the treatment of opaque posterior capsule which is unique and magical approach for improvement of vision and restoration of effective life style. Every procedure have some adverse effect, Nd yag laser capsulotomy also have some complications .but benefit are tremendous if we can go in proper way. Medicine Today 2023 Vol.35(2): 91-94

Выяснение взаимосвязи между формированием регматогенной отслойки сетчатки и проведенной ИАГ-дисцизией вторичной катаракты

Aim. Retrospective analysis of case histories of patients operated at Khabarovsk branch of S. N. Fedorov “NMRC “MNTK “Eye microsurgery” for rhegmatogenous retinal detachment in 2013–2016, who had previously undergone Nd:YAG laser posterior capsulotomy. Methods. Method of continuous sampling was used. During the study period, 19 cases of retinal detachment were identified in patients who had previously undergone Nd:YAG laser posterior capsulotomy. There were 5 women (26 %), 14 men (74 %). Mean age of patients was 63±0.5 years (from 59 to 65 years). Probable causes of retinal detachment development were analyzed. Results. It was revealed that in the early postoperative period development of retinal detachment is caused by formation of retinal horseshoe tears and more often in patients with hyperopia, emmetropia and myopia of low degree. In the late postoperative period, development of retinal detachment is associated with progression of predictively dangerous forms of peripheral retinal degeneration and more often in patients with high myopia. Conclusion. Thorough examination of periphery of the retina in early and late postoperative periods and carrying out barreer laser coagulation of the retina are measures of prevention of retinal detachment after Nd:YAG laser posterior capsulotomy. Key words: secondary cataract; Nd:YAG laser posterior capsulotomy; retinal detachment.

Response to query and additional considerations regarding the article "The complication rate following neodymium-doped yttrium aluminum garnet laser posterior capsulotomy for posterior capsular opacification in patients with and without comorbidities".

Response to query and additional considerations regarding the article "The complication rate following neodymium-doped yttrium aluminum garnet laser posterior capsulotomy for posterior capsular opacification in patients with and without comorbidities".

Beyond the Blur: Clinical Outcomes of Nd: YAG Laser Posterior Capsulotomy Intraocular Pressure, Refraction, Anterior Chamber Depth, and Macular Thickness

Background: Nd: YAG laser posterior capsulotomy is a commonly performed procedure to treat posterior capsular opacification following cataract surgery. While the procedure is known to effectively improve visual acuity, its potential impact on Intraocular Pressure (IOP), refraction, Anterior Chamber Depth (ACD), and macular thickness remains a subject of debate. This study aims to investigate the effects of Nd: YAG laser posterior capsulotomy on these ocular parameters. Methods: This study was designed as a prospective analysis conducted at a tertiary eye care center on patients who underwent Nd: YAG laser posterior capsulotomy between January 2020 and December 2020. Preoperative and postoperative measurements of IOP, refraction, ACD, and macular thickness were collected and compared. Statistical analyses were performed using paired t-tests, and p-values<0.05 were considered statistically significant. Results: A total of 30 eyes from 25 patients (mean age, 65.4±8.2 years) were included in the analysis. Following Nd: YAG laser posterior capsulotomy, the mean IOP from 15.2±2.3 mmHg to 17.0±2.7 mmHg (p<0.001). The refractive status showed a mean myopic shift of -0.35±0.16 diopters (p<0.001,). Additionally, there was a statistically significant reduction in ACD from 3.15±0.42 mm to 2.90±0.37 mm (p=0.003,). However, there was no statistically significant change in macular thickness after the procedure (p=0.287). Conclusion: Nd: YAG laser posterior capsulotomy leads to a mild but statistically significant increase in IOP and a small myopic shift in refraction. Additionally, the procedure results in a decrease in ACD but does not significantly affect macular thickness. Ophthalmologists should consider these effects when performing Nd: YAG laser posterior capsulotomy and carefully monitor patients postoperatively.

Acute Effects of Neodymium-Doped Yttrium Aluminum Garnet Laser Capsulotomy on Anterior Segment Parameters in Capsular Bag Distension Syndrome.

Background: Capsular bag distension syndrome (CBDS) can be effectively treated using either Neodymium-doped Yttrium Aluminum Garnet (Nd:YAG) laser capsulotomy or surgery. Assessing anterior segment, particularly immediately after Nd:YAG laser capsulotomy, could provide clinically relevant information on ocular dynamics, refractive changes, and complication mechanisms, especially in late postoperative CBDS. Objective: To explore the acute effects of Nd:YAG laser posterior capsulotomy on anterior segment parameters in late postoperative CBDS. Methods and results: In this study, 20 patients underwent Nd:YAG laser posterior capsulotomy after cycloplegia, during which milky-white fluid material migrated into the anterior vitreous. Anterior segment parameters were assessed before and immediately after laser using Scheimpflug-Placido topographer. The main outcome measures were differences in best-corrected visual acuity (BCVA), aqueous depth (AqD), anterior chamber volume (ACV), iridocorneal angle (ICA), corneal volume (CV), and central corneal thickness (CCT) at the baseline versus at immediately after laser. The mean age and duration since surgery for CBDS presentation were 70.25 ± 6.21 and 6.15 ± 1.31 years, respectively. The AqD, ACV, ICA, and spherical equivalent increased significantly compared with baseline (4.18 vs. 4.02 mm, p = 0.001; 177 vs. 173.55 mm3, p = 0.004; 51.15° vs. 50.15°, p = 0.023; -1.00 vs. -2.00 D, p = 0.003, respectively). These changes were also associated with significantly improved BCVA an hour after capsulotomy [0.2 (0.05-0.2)] relative to baseline [0.3 (0.2-0.5)], (p = 0.001). CCT and CV decreased nonsignificantly; horizontal AC diameter and K1 and K2 increased nonsignificantly (p > 0.05). Conclusions: Nd:YAG laser posterior capsulotomy appears to be an effective CBDS treatment for acutely improving vision, potentially due to immediate refractive changes caused by altered anterior segment parameters.

Assessment of Endothelial Cell Count Changes Post-Yttrium Aluminium Garnet Laser for Posterior Capsular Opacification

Objective: The study aimed to assess the effect of Neodymium : Yttrium Aluminium Garnet laser (ND:YAG laser) on endothelial cell count loss and anterior segment elements. Study Design: Quasi-experimental. Place and Duration Of Study: Armed Forces Institute of Ophthalmology, Rawalpindi from Jul 2021 to Feb 2022. Methodology: A total of 60 patients with a history of posterior capsular opacities planned for Neodymium: Yttrium Aluminium Garnet laser posterior capsulotomy were included. Specular microscopy was done pre and post-laser to study and parameters such as central corneal thickness, endothelial cell count, intra-ocular pressure was noted. Data were analyzed by using the Statistical Package for the Social Sciences version 23 software Result: After four weeks of Neodymium : Yttrium Aluminium Garnet laser, there was no significant change in the intraocular pressure (p=0.334), however, the visual acuity improved from 0.6±0.3-0.05±0.1 (p<0.001) along with a decrease in endothelial cell count 2101±485-1919±427 (p<0.001) and central corneal thickness 0.504±0.03-0.502± 0.03 (p=0.010). A similar trend of changes in the parameters was observed for lower (1.0-1.2MJ) and higher energy (2.1-2.5MJ) in the sample for posterior capsulotomy. Conclusion: Our study concluded that the corneal structural changes occur post-Neodymium: Yttrium Aluminium Garnet posterior capsulotomy, including changes in endothelial cell count. However, there is no significant disturbance in the intraocular pressure after the procedure.

Clinical Outcomes of Nd: YAG Laser Posterior Capsulotomy: Impact on Intraocular Pressure, Refraction, Anterior Chamber Depth, and Macular Thickness

Background: Nd: YAG laser posterior capsulotomy is a commonly performed procedure to treat posterior capsular opacification following cataract surgery. While the procedure is known to effectively improve visual acuity, its potential impact on intraocular pressure (IOP), refraction, anterior chamber depth (ACD), and macular thickness remains a subject of debate. This study aims to investigate the effects of Nd: YAG laser posterior capsulotomy on these ocular parameters. Methods: This study was designed as a prospective analysis conducted at a tertiary eye care center on patients who underwent Nd: YAG laser posterior capsulotomy at a tertiary eye care center between January 2020 and December 2020. Preoperative and postoperative measurements of IOP, refraction, ACD, and macular thickness were collected and compared. Statistical analyses were performed using paired t-tests, and p-values <0.05 were considered statistically significant. Results: A total of 30 eyes from 25 patients (mean age, 65.4 ± 8.2 years) were included in the analysis. Following Nd: YAG laser posterior capsulotomy, the mean intraocular pressure (IOP) increased from 15.2 ± 2.3 mmHg to 17.0 ± 2.7 mmHg (p < 0.001). The refractive status showed a mean myopic shift of -0.35 ± 0.16 diopters (p < 0.001,). Additionally, there was a statistically significant reduction in anterior chamber depth (ACD) from 3.15 ± 0.42 mm to 2.90 ± 0.37 mm (p = 0.003,). However, there was no significant change in macular thickness after the procedure (p = 0.287). Conclusion: Nd: YAG laser posterior capsulotomy leads to a mild but statistically significant increase in IOP and a small myopic shift in refraction. Additionally, the procedure results in a decrease in ACD but does not significantly affect macular thickness. Ophthalmologists should consider these effects when performing Nd: YAG laser posterior capsulotomy and carefully monitor patients postoperatively.

Stability of neodymium:YAG laser posterior capsulotomy in eyes with capsular tension rings.

To evaluate the stability of neodymium (Nd):YAG laser posterior capsulotomy in eyes with capsular tension rings (CTRs). A total of 60 eyes that underwent cataract surgery and laser posterior capsulotomy postoperatively were included in this retrospective cohort study. To evaluate the safety and stability of capsulotomy, changes in the size of posterior capsulotomy and anterior chamber depth (ACD) in three groups: the group without CTR, the group with 12 mm CTRs, and the group with 13 mm CTRs, at 1wk, 3, 12, and 15mo after capsulotomy, were compared. In the group without CTR and the group with 12 mm CTR, there was no significant change in ACD at every post-laser follow-up. In the group with 13 mm CTR, the ACD change was significant until 3mo after capsulotomy. In all groups, there was a significant increase in the area of capsulotomy between 1wk and 3mo post-laser. Between 3 and 12mo post-laser, only the group with 13 mm CTR showed a significant increase in the area of capsulotomy (P<0.01). Laser posterior capsulotomy is safe in all three groups. The capsulotomy and ACD become stabilized and have not shown significant changes since 1y post-laser, even with larger CTRs. The maintenance of centrifugal capsular tension can last longer with larger CTRs, and the stability of the capsulotomy site can be reached about 12mo after capsulotomy in pseudophakic eyes with larger CTRs.

Factors Associated with Reclosure of Posterior Capsule Aperture by Flat Opacifications with Pearls after Nd:YAG Laser Posterior Capsulotomy.

In this retrospective case series, we investigated factors associated with posterior capsule aperture (PCA) reclosure following neodymium-yttrium aluminum garnet (Nd:YAG) laser posterior capsulotomy. The study encompassed patients who underwent cataract surgery with intraocular lens (IOL) implantation or a combined vitrectomy, cataract surgery, and IOL implantation between 2009 and 2022. PCA reclosure was observed in 22 eyes of 17 patients: 45% (10 eyes) underwent the triple procedure, and 55% (12 eyes) received cataract surgery with IOL implantation. In our clinic, 14% of patients were given IOLs with a 4% water content, while 73% (13 eyes) of those experiencing PCA reclosure had IOLs with a 4% water content. The mean interval between Nd:YAG capsulotomies was notably shorter than that between the initial cataract surgery and the first Nd:YAG laser capsulotomy. We also identified five stages of PCA reclosure progression. In conclusion, IOL water content may be linked to PCA reclosure, and the time to recurrence is shorter with each successive reclosure. Further research is needed to verify these findings and uncover additional contributing factors.

Effects of Nd: YAG Laser Capsulotomy on Visual Acuity, Central Macular Thickness, Intraocular Pressure and Refraction in Patients with Diabetes Mellitus

Aim: This study aimed to evaluate the effects of Nd: YAG laser posterior capsulotomy (YAG PC) on best-corrected visual acuity (BCVA), central macular thickness (CMT), intraocular pressure (IOP), and refraction in patients with diabetes mellitus (DM). Material and Methods: This retrospective study included patients who underwent YAG PC due to posterior capsular opacification (PCO). BCVA, refraction examination results, IOP, and CMT of the patients were evaluated. All patients were examined before, one day, and one month after the treatment. Results: The study included 56 eyes from 48 diabetic patients (diabetic group, Group 1) and 61 eyes from 50 nondiabetic patients (nondiabetic group, Group 2). In Group 1, a significant increase was observed between pre-treatment BCVA and the first-day and first-month BCVAs. Similarly, a significant increase was observed on the first day and first-month CMT compared to the pre-treatment CMT. On the other hand, a significant increase was observed in Group 2 between pre-treatment BCVA and the first-day and first-month BCVAs. However, no significant increase was observed between pre-treatment and the first-day and first-month CMT. Conclusion: Although CMT has increased in patients with DM after YAG PC, applied for PCO treatment, this increase did not affect the visual recovery.

Comparison of the Rate of Posterior Capsule Opacification Following Combined Treatment With Topical Dexamethasone 0.1% Plus Ketorolac 0.5% Eye Drops Versus Dexamethasone 0.1% Alone: A Two-Year, Randomized Clinical Investigation.

Background and aim The use of non-steroidal anti-inflammatory drugs in animals decreases the incidence of posterior capsular opacification (PCO) following cataract surgery. We evaluated the rate of PCO in patients with cataract surgery and foldable "in the bag" posterior chamber intraocular lens (PC-IOL) implantation treated with combined dexamethasone 0.1% plus ketorolac tromethamine 0.5% versus dexamethasone 0.1% alone. Materials and methods A total of 114 eyes of 101 patients underwent uneventful corneal small-incision phacoemulsification with primary implantation of a foldable acrylic PC-IOL (AcrySof®, Alcon, Fort Worth, USA). Postoperatively for four weeks, group 1 eyes were treated with dexamethasone 0.1% plus ketorolac tromethamine 0.5% ophthalmic solutions four times daily for each whereas group 2 eyes were treated with dexamethasone 0.1% alone. Other regiments were the same for each group. Patients were evaluated between one- and four-yearfollowing surgery. The frequency and timing of severe PCO following surgery that needed Nd:YAG laser posterior capsulotomy were recorded and evaluated. Results The mean (SEM) age of group 1 (n = 54) and group 2 (n = 60) at operation was similar (62.8 ± 2.2 vs. 60.6 ± 1.7 years, respectively). Eighty-eight patients had unilateral cataract and 13 cases had bilateral disease. Overall, the mean follow-up duration was 24.7 months postoperatively (range, 15-48). Clinically significant PCO that finally needed Nd:YAG laser application developed in two eyes (3.7%) in group 1 and in four eyes (6.6%) in group 2, and the difference was not statistically significant (p>0.05). The mean month at capsulotomy was 26.5 in group 1 and 24.3 months in group 2 eyes (p>0.05). Conclusions Topical instillation of ketorolac ophthalmic solution in the immediate period after phacoemulsification and PC-IOL implantation did not seem to influence the incidence of PCO formation two years after cataract surgery.

Vitreous prolapse with intraocular lens decentration – An uncommon complication following neodymium-yttrium aluminum garnet laser capsulotomy

Vitreous prolapse and intraocular lens decentration following neodymium-doped yttrium aluminum garnet (Nd:YAG) laser posterior capsulotomy is rare. We report a case of a patient who developed blurring of vision, due to vitreous prolapse and decentration of the intraocular lens, following Nd:YAG laser capsulotomy for posterior capsular opacification (PCO), which was restored to complete visual recovery with surgical management. The report aims to highlight the importance of precise focusing, usage of minimum optimal power required, and appropriate sizing of Nd:YAG laser posterior capsulotomy. Although Nd:YAG laser posterior capsulotomy is a safe procedure for treating PCO, it is not free from complications.