Nd-YAG Laser Capsulotomy Research Articles

An Investigation Comparing the Efficiency of Timolol 0.5% with Brimonidine 0.2% in Managing the Increase in Intraocular Pressure Subsequent to Nd-Yag Laser Capsulotomy

Objective: Conducting a comparison between the efficacy of Timolol 0.5% eye drops and Brimonidine 0.2% eye drops in managing the elevation of intraocular pressure post Nd-YAG laser capsulotomy. Study Design: Employed a randomized controlled trial. Methodology: The research involved 80 patients (one eye per patient) aged between 45 and 70, diagnosed with posterior capsular opacification scheduled for Nd-YAG laser capsulotomy at the Department of Ophthalmology, Mathuradas Mathur Hospital (Dr. S. N. M. C.) in Jodhpur. The patients were divided into two groups, X and Y, each consisting of 40 individuals. Baseline intraocular pressure was measured using an applanation tonometer before administering eye drops. Group X received a single drop of Timolol 0.5%, while group Y received a single drop of Brimonidine 0.2% one hour prior to capsulotomy. Intraocular pressure was recorded at 1 hour and 4 hours post the laser procedure. Results: Both groups comprised 40 patients each. The baseline IOP was 16±2.16 for group X and 15±2.56 for group Y. There was no statistically significant variance between the two groups in mean IOP changes at 1 hour following Nd-YAG laser capsulotomy. However, after 4 hours, the mean reduction in IOP was -1.54 mmHg for group X and -1.85 mmHg for group Y (p<0.5). Conclusion: Our study indicates that both Timolol 0.5% eye drops and Brimonidine 0.2% eye drops are similarly effective in controlling elevated intraocular pressure after Nd-YAG laser capsulotomy

Posterior capsule opacification assessment of need and outcome of Nd-YAG laser capsulotomy: a follow up of rapid assessment of avoidable blindness in a district in central India

Background: Current study highlights the burden of PCO related blindness, need of Nd YAG laser in rural set up and positive and negative outcomes of Nd-YAG laser capulotomy in treating PCO. Methods: This study was conducted in 2020 at the department of ophthalmology at a medical college in central india. A total 53 such eyes were studied. Results: A 408 individuals were included with pseudophakia in one or both eyes. Mean age of pseudophakic study population was 67.9±7.6 years (range 50-92 years). Nearly 50% of the eyes had a visual acuity of less than 6/18. 40% of the pseudophakic eyes had visually significant PCO. There were 53 eyes where the visual impairment was solely due to PCO and Nd-YAG Laser capsulotomy was done for these eyes. Post Laser Treatment 79.2% of treated eyes achieved a visual acuity of ≥6/18. Most commonly encountered complications after YAG Laser Capsulotomy was IOP spike which was seen in 29.5% of eyes undergoing the procedure which was followed by IOL pitting seen in 29.7%. Conclusions: The reach of Nd-YAG laser capsulotomy is limited to these masses. A step to prevent blindness in this category of population would be to ensure vailibility of Nd-YAG laser capsulotomy. This procedure is relatively safe with few complications.

A Study of Visual Improvement and Variation in IOP Following Nd-YAG Laser Capsulotomy

AIM: To study the visual improvement and to correlate the effect of energy used and number of shots with post procedural IOP spike following Nd-YAG laser capsulotomy cases. MATERIALS AND METHODS: A total of 36 patients presented with pseudophakia with PCO attending ophthalmology outpaient department at Rajah Muthiah medical college hospital during the period of October 2020 - December 2022 were included in the study. Patients with glaucoma, Uveitis, high myopia, posterior segment disorders will be excluded from the study. The patient will be subjected to visual acuity testing, detailed slit lamp examination, IOP measurement using Non-contact tonometer pre and post laser procedure and detailed fundus examination done and results were interpreted. OBSERVATION: Among the total 36 participants, 31.4% belong to age group 56 to 65 years followed by 28.6% in the age group 66 to 75 years. 51.4% were males and 48.6% were females. Of the total participants 28.6% had visual acuity of 6/24 in the affected eye and 22.9% had visual acuity of 6/36 in the affected eye.one subject presented with visual acuity of hand movements (HM) only in the involved eye.The mean pre-operative intraocular pressure among the participants was 1.85±0.73. 45.7% had preoperative IOP of 13 to 16 mmHg and 34.3% had preoperative IOP of 8 to 12. The mean number of YAG shots among the participants was 1.96±0.81. 36.3% were provided with 5 to 8 YAG shots and 33.3% with 2 to 4.The mean IOP among the participants in the preop was 14.03±2.92. The mean IOP immediately after the intervention was 15.29±2.83.The mean IOP 20 mins after the intervention was 17.43±2.96.Our study shows that the change in mean IOP after ND YAG LASER administration was significant with P value of less than 0.05 and also our study shows improvement in post laser BCVA with significant P values CONCLUSION: The study concluded that all patients had good visual recovery. The post laser IOP raise is minimal and transient. It varies with amount of laser energy used. Hence recommended to use minimum possible laser energy and must be followed up for raised intraocular pressure changes. Keywords: Intraocular pressure, Neodymium: Yttrium Aluminium GARNET Capsulotomy.

To Evaluate the Efficiency with which Patients who have had ND-YAG Laser Capsulotomy may Reduce their Intraocular Pressure with a Predetermined Dosage of Brimonidine/Tart-Rate [0.2%] and Timalol/Maleate [0.5%

Background: The most prevalent type of glaucoma, known as primary open-angle glaucoma (POAG), is a major contributor to preventable blindness worldwide. Treating hypertensive ocular diseases, such as elevated intraocular pressure (IOP), may decrease the development and progression of (POAG). Objective: this study was to evaluate the efficiency with which patients who have had Nd-Yag laser capsulotomy may reduce their intraocular pressure with a predetermined dosage of brimonidine tartrate 0.2% and timalol maleate 0.5% Method: From January 2022 to January 2023, a prospective, randomized trial was conducted in the Department of Ophthalmology at KMC and KTH Peshawar. Sample size 100 patients who had undergone (Nd-Yag-laser capsulotomy) were enrolled in the study. After random selection, 50 patients were divided into two groups. Group 1 received (timolol maleate) [0.5%] BID daily and Group 2 received [0.5%] (timolol maleate) in a constant proportion in addition to (0.2%) brimonidine tartrate BID daily. Intraocular pressure (IOP) was assessed at the beginning, after one week, three weeks, and four weeks. The mean IOP at 4 weeks served as the major outcome indicator. Mean IOP at 1 week, 3 week, and 4 week intervals were included as secondary end measures. Descriptive statistics, the Student's t-test, and one-way ANOVA were used to analyse the data. Results: Mean IOP at baseline not significant with in two groups [P=0.36]. At one week, the mean IOP in the timolol group was 15.3 3.3 mmHg, compared to 13.1 2.9 mmHg in the timolol/brimonidine (P=0.001). At 3 weeks, (mean IOP) in the (timolol-group) was 14.4 3.1 mmHg, compared to 12.5 2.8 mmHg in the timolol/brimonidine group (p 0.001). At 4 weeks, the mean IOP in the timolol group was 13.8 3.1 mmHg, compared to 11.7 2.7 mmHg in the timolol/brimonidine group (p 0.001). Conclusion: this study show that persons who have had Nd-Yag laser capsulotomy benefit from a blending together timolol maleate [0.5%] and brimonidine tartrate [0.2%] to significantly reduce intraocular pressure (IOP). Keywords: Intraocular Pressure,ttimolol- maleate, brimoni-dine- tartrate, Nd-Yag Laser-Capsulotomy

The evaluation of the effect of Nd-YAG capsulotomy on posterior ocular vascular structures by Optical coherence tomography angiography

BackgroundWe aimed to examine the changes in retinal, choroidal and optic nerve head vascular structures after Nd-YAG laser application due to posterior capsule opacification after cataract surgery by Optical coherence tomography angiography (OCTA). MethodsFifteen eyes of 15 patients who have posterior capsule opasification and underwent Nd-YAG laser capsulotomy were included in the study. OCTA imagings of patients were made before and one hour, one week and one month later after the laser procedure. ResultsNo significant change was determined before and after capsulotomy in macular thickness measurements, flow areas and vessel densities (all p > 0.05). Optic nerve head vessel densities and flow areas didn't differ preoperatively and postoperatively (p > 0.05). ConclusionsNd-YAG laser capsulotomy for posterior capsule opacification has no detectable effect on macular and optic nerve flows and vessel densities.

To compare the efficacy of timolol maleate 0.5% vs fixed combination of timolol maleate 0.5%, and brimonidine tartrate 0.2% in control of raised intra ocular pressure in patients undergone Nd-Yag laser capsulotomy.

Purpose: The purpose of the study is to compare the efficacy of Timolol maleate alone vs fixed combination of Timolol maleate 0.5% with Brimonidine 0.2% in patients undergone Nd-Yag laser capsulotomy.
 Methodology: 100 patients with posterior capsular opacification were enrolled though OPD. They were placed in 2 groups with 50 patients each. Group A received Timolol maleate 0.5% alone while group B received combination of timolol maleate with Brimonidine tartrate.
 Results: In group A 3 patients developed acute raise of intraocular pressure despite of Timolol maleate use while goup B patients who received combination of Timolo maleate and Brimonidine had controlled intraocular pressure.
 Conclusion: Fixed combination of Timolo maleate 0.5% and Bremonidine tartrate 0.2 % is more effective in controlling of IOP raise in patients undergone Nd-Yag laser capsulotomy for posterior capsular opacification then Timolo maleate0.5% alone.

Utility of Abraham Lens in YAG Laser Capsulotomy: A Prospective Study

Introduction: Neodymium-doped Yttrium Aluminum Garnet (Nd: YAG) laser capsulotomy remains the safest treatment for Posterior Capsular Opacification (PCO). The use of capsulotomy lens has some benefits to offer especially when learning the procedure and in uncooperative patients. With changing curriculum in medical teaching which focusses more on practical aspects it will serve as an asset for the trainees. Even if not used routinely its importance cannot be altogether undermined. Aim: To assess the utility of Abraham capsulotomy lens in YAG laser capsulotomy procedure and compare it with capsulotomy performed without lens. Materials and Methods: This was a prospective, longitudinal study conducted in the Department of Ophthalmology, Kalinga Institute of Medical Sciences, Bhubaneswar, Odisha, India, from June 2020 to February 2021. A total of 79 patients who developed PCO after more than six months of cataract surgery and had decrease in visual acuity on Snellen’s chart by two or more lines from baseline were included. Visual acuity, Intraocular Pressure (IOP) measurement, fundoscopy, Ocular Coherence Tomography (OCT) was done for Central Macular Thickness (CMT) in all patients at presentation, one and three months following YAG capsulotomy. Nd-YAG laser capsulotomy was then done with and without the use of Abraham’s capsulotomy lens in two groups. Parameters such as visual acuity change, IOP, CMT, energy used in capsulotomy, type of PCO were then compared between the two groups. Independent t-test, repeated Analysis of Variance (ANOVA) and Spearman’s correlation tests were used to analyse the data. Results: Of the 79 patients, 40 underwent capsulotomy without the Abraham lens (Group 1) and 39 with Abraham lens (Group 2). Females were more than males in both the groups. The improvement in visual acuity was statistically significant in both groups. There was statistically significant difference in CMT in both groups at each visit. The average energy used for dealing with fibrous type of calcification was significantly more than that used in elsching pearls (13.96 mj). Complications like Intraocular Lens (IOL) pitting, raised IOP, cystoid macular oedema, uveitis and retinal detachment were encountered which were managed by appropriate medical and surgical therapy. Conclusion: Use of capsulotomy lens decreases the amount of energy needed for capsulotomy and helps to stabilise the eye and to focus better especially for ophthalmologists in their initial training days.

Pars Plana Capsulectomy with Scissors and Micro Forceps: A Case Report of an Alternative Approach for Membranous Posterior Capsule Opacity

Pediatric eye injuries are the leading cause of unilateral blindness in childhood. Post-traumatic cataract development is common, and the risk of posterior capsule opacity occurrence is seen at a high rate. Nd-YAG laser capsulotomy or anterior vitrectomy may useful, but some patients develop thick posterior membranous capsule opacity and mentioned techniques may not be performed. A 6-year-old girl who had a corneal tear repair, traumatic cataract and thick posterior capsule membrane, which could not be cleared by Nd-YAG laser or vitrectomy, was removed with scissors and micro forceps through the pars plana vitrector entrances. Here, we present a case report as an alternative method of posterior capsulectomy.

A prospective observational study for the safety of Nd-YAG Laster posterior capsulotomy procedure in patients of Posterior Capsular Opacification (PCO) at the ophthalmology outpatient department of a tertiary care teaching hospital in western India

: Nd YAG laser is preferred method to manage thickened posterior capsule because it is an easy, non-invasive and an OPD basis procedure considering the comfort of the patients.: The present study was carried out with objectives to evaluate the safety profile of Nd-YAG Laser Capsulotomy mainly in terms of rise in intraocular pressure (IOP) and other intra as well as post-operative complications.This prospective observational study was carried out with prior Institutional Ethics Committee (IEC) approval and written informed consent from the participants at Ophthalmology Outpatients Department (OPD) of a tertiary care teaching hospital of western India, for the duration of two years from Oct’2015 to Sept’2017. A detailed ocular, systemic, family history was taken of all the enrolled patients with pre- and post-procedure evaluation of IOP by Goldman’s Applanation Tonometry, Slit lamp examination and Fundus examination by direct and indirect ophthalmoscopy. Capsulotomy was done using VISULAS YAG III laser of Zeiss company.The data was entered and tabulated in Microsoft Excel 2007 and analyzed. Data was analyzed by frequency distribution. The ‘p’ value was determined to finally evaluate and P <0.05 was considered as statistically significant.Acute transient rise of IOP up to 5mmHg or more (P value <0.001) was found in Nine cases which is highly significant compared with pre-procedural stage. Intraocular lens pitting was observed in Four cases. Cystoid macular edema was found in one case. Two patients developed mild iritis. Nd-YAG laser capsulotomy is an easy, practical modality to treat posterior capsular opacities, but is not a completely innocuous procedure. Nd-YAG laser capsulotomy is an easy, practical modality to treat posterior capsular opacities, but is not a completely innocuous procedure. Due precautions should be taken in pre- and post-procedural stages including medications, thorough counselling, proper focusing and steady fixation of the patients to minimise the complication.

Role of Optical Coherence Tomography (OCT) in Early Detection of Subclinical Cystoid Macular Edema after Nd-YAG Laser Capsulotomy

Purpose: To determine role of optical coherence tomography (OCT) in early detection of subclinical cystoid macular edema (CME) after Nd-YAG laser capsulotomy in patients with posterior capsular opacification (PCO).
 Study Design: Descriptive case-series.
 Place and Duration of Study: Department of Ophthalmology Unit 1, Dow University of Health Sciences and Civil Hospital Karachi from 1-July-2015 to 31-Dec-2015.
 Methods: A total of 72 eyes with unilateral or bilateral visually significant PCO following uncomplicated cataract surgery with posterior chamber intraocular lens implantation were included in the study. Patients with corneal opacities, glaucoma, retinopathy, maculopathy, optic neuropathy, complicated cataract surgery, previous ocular surgery other than cataract surgery and High refractive errors were excluded from the study. Best-corrected visual acuity (BCVA), Slit lamp examination, posterior segment examination and macular thickness was measured using spectral domain (TOPCON 3D OCT) optical coherence tomography before laser and at 1 week and at 1 month after laser.
 Results: Mean age was 55.76 ± 5.28 with Confidence interval of 55.02 – 56.49 years. Eighty-one were males and 122 were females. Subclinical cystoid macular edema (CME) was found in 10 (14%) patients. Out of the patients who had CME, 3 were in age group of 40-55 years and seven were in age group of 56-70 years. P value was found to be significant i.e. (P = 0.039).
 Conclusion: Optical coherence tomography OCT is a non invasive and useful tool for early detection and management of subclinical cystoid macular edema after Nd-YAG laser capsulotomy in patients having posterior capsular opacification (PCO).
 Key Words: Cystoid Macular Edema, Nd-YAG laser, Posterior Capsular Opacification. Optical Coherence Tomography (OCT).

Visual outcomes and complications after Neodymium-doped yttrium aluminium garnet laser capsulotomy in Posterior capsular opacification

Visual outcomes and complications after Neodymium-doped yttrium aluminium garnet laser capsulotomy in Posterior capsular opacification - IJCEO- Print ISSN No: - 2395-1443 Online ISSN No:- 2395-1451 Article DOI No:- 10.18231/j.ijceo.2019.116, Indian Journal of Clinical and Experimental Ophthalmology-Indian J Clin Exp Op

Visual outcome after ND: YA Glaser posterior capsulotomy in pseudophakic patient

Background: Posterior capsular opacification (PCO) also called as “after cataract” is a common complication following extra capsular cataract surgery with or without posterior chamber intraocular lens implantation.An opaque membrane develops as retained cells proliferate and migrate on the posterior capsular surface. Material and Methods: The study included a total of 100 eyes of 100 patients who were diagnosed to have posterior capsular opacification and were fulfilling all the inclusion and none of the exclusion criteria. After that they were taken for a detailed clinical examination. All patients underwent Nd:YAG laser capsulotomy and were followed up at 1 week, 1 month and at 3 months. At every follow-up detailed examination was done. BCVA and any complications were noted. Results:Of the 100 patients, 45 (45%) were male and 55 (55%) were female. Majority of the patients were in the age group 61-70 years. The average time interval between cataract surgery and Nd-YAG laser capsulotomy was between 2-4 years. In the type of PCO seen,84 (84.0%) patients were having Elsching pearls type of PCO, 8 (8.0%) patients were having fibrous type of PCO and 8 (8.0%) patients were having Sommering ring type of PCO. The pre laser visual acuityin more than 62% of eyes was 6/60 to FC while 38% had visual acuity of 6/36 to 6/18. Visual acuity of 6/18 or better was achieved in 27% of eyes while 73% recovered to 6/12 to 6/6. None of these eyes showed further deterioration in visual acuity. The highest energy requirement was in the Fibrous PCO s0.89 ± 0.15 J, followed by Sommering Ring PCO 0.70 ± 0.17 J and least energy was in Elsching pearls 0.47 ± 0.24 J. The comparison of mean energy between the type of PCO was found to be statistically significant (P<0.05), showing that the mean energy was varying between the types of PCO. Conclusion: Neodymium-YAG capsulotomy for PCO is rewarding procedure inadults and has good visual outcome.

To evaluate the effects of Nd:YAG laser posterior capsulotomy on best corrected visual acuity (bcva) and intraocular pressure

Background: Nd:YAG laser is non-invasive and effective means to deal with the posterior capsule opacification.However safe it may have some inherent complications. Rise of intraocular pressure is frequently encountered and incompletely understood complication of YAG laser capsulotomy and documented with conflicting results.Aims and Objective: To assess the efficacy of Nd: YAG laser capsulotomy in term of visual outcome(Best Corrected Visual Acuity) and also study the changes in IOP after the procedure.Materials and Methods: Study evaluated the changes in IOP and visual acuity after Nd-YAG laser capsulotomy in 100 eyes with significant PCO after uncomplicated cataract surgery with IOL implantation. Complete ocular examination including visual acuity, anterior segment examination with slit lamp, fundus and applanation tonometry were performed pre and post-laser in all cases. Posterior capsulotomy was done with VISULAS YAG III Q-switched Nd: YAG laser machine by ZEISS. IOP was recorded before and then at 1hour, 1 Day, 1 week and 1 month post-laser in order to determine the IOP changes.Results: Pre-laser visual acuity ranged from 1/60 to 6/12. Results showed statistically significant improvement in BCVA with 70% patients had BCVA 6/6, 21% had BCVA 6/9 and 8% having BCVA 6/12 post-laser at 1 month. It was observed that 36% of the patients showed no change in IOP while 64% patients showed elevated IOP. Among these 59% patients show rise in IOP that was ≤5 mm Hg while only 5% of the patients had a rise of more than IOP &gt;5 mm Hg. Most of these patients achieved their baseline IOP within 1 day and only 7 % patient had rise in IOP compared to baseline IOP on day 1. None of the patients show elevated IOP after 1 week.Conclusion: Our study showed that Nd: YAG laser posterior capsulotomy provided excellent results in terms of visual improvement and most of the patients had a rise of &lt;5mm Hg which was transient in nature and routine antiglaucoma medication may not be needed in all the patient undergoing Nd;Yag capsulotomy, however caution should be exercised in glaucomatous, aphakic, high myopic and other high risk patients.Asian Journal of Medical Sciences Vol.8(5) 2017 93-97

Study of Variation in Intraocular Pressure Spike (IOP) Following Nd- YAG Laser Capsulotomy

Posterior Capsular Opacifications (PCO) is a frequent complication of cataract surgery following posterior chamber intraocular lens implantation. Nd -Yag laser capsulotomy is the treatment of choice for PCO and is known to be associated with complications like Raised Intraocular Pressure (IOP), Intraocular lens pitting, intraocular lens cracks, cystoid macular oedema, retinal detachment, corneal burns. Raised IOP is the most common complication and prescribing anti-glaucoma drugs post capsulotomy is a common practise. Our study helps us to anticipate the post procedural IOP rise in specific patients and treat only selected group of patients with anti- glaucoma medications. To study and correlate the effect of energy used and number of shots with post procedural IOP spike following Nd-YAG laser capsulotomy cases. All patients with PCO presenting to Ophthalmology Out Patient Department at Sri Siddhartha Medical College between November 2014 to November 2015 were included. All the patients with glaucoma, uveitis and high myopia were excluded from the study. Data relevant to history, ocular examination and IOP were recorded. Significant correlation of IOP spike with the number of Nd- YAG Laser shots delivered was found by One-way ANOVA Post-Hoc Tukeys Test. The p-value was significant for shots more than 40, provided the energy was restricted to 20 mJ and below. Correlation of energy with IOP spike was not significant as found by One-way ANOVA, Post-Hoc Tukey test. Predictability of 2 hours post-procedure IOP regarding persistent IOP rise was significant. It was observed that all pseudophakic patients may not require anti-glaucoma medication pre, or post Nd YAG laser capsulotomy. Only patients who required more than 40 shots during the procedure would need a close observation and if persistent rise is documented, ocular hypotensives may be advised.

Liquefaction in the Prevention of Posterior Capsule Opacification–Safety and Efficacy

Purpose: To evaluate the extent of posterior capsule opacification (PCO) following cataract surgery – torsional phacoemulsification with liquefaction method removal of the epithelial cells (right eye), and straight forward torsional phacoemulsification (left eye), with subsequent implantation of the AcrySof SA60AT intraocular lens. Methods: In this prospective clinical trial patients with bilateral cataract were observed. The Evaluation of Posterior Capsule Opacification (EPCO) 2000 software and the Open-Access Systematic Capsule Assessment (OSCA) system were used for PCO assessment at 3, 6, 12 and 24 months after surgery. Postoperative changes in endothelial cell count (ECC) and pachymetry were also evaluated. Results: The mean value for total EPCO index at 3, 6, 12 and 24 months postoperatively was respectively for the right eye 0.289 ± 0.223, 0.276 ± 0.176, 0.309 ± 0.185 and 0.418 ± 0.253, and for the left eye 0.302 ± 0.191, 0.301 ± 0.168, 0.355 ± 0.206 and 0.468 ± 0.309. The mean value for OSCA score (New Analysis) was for the right eye 0.612 ± 0.279, 0.603 ± 0.339, 0.559 ± 0.265 and 0.642 ± 0.401, and for the left eye 0.630 ± 0.398, 0.629 ± 0.366, 0.535 ± 0.331 and 0.574 ± 0.340. One patient underwent Nd-YAG laser capsulotomy one year after surgery (both eyes), and one patient two years postoperatively (right eye). There was minimal reduction in endothelial cell count and minimal changes in corneal thickness in both eyes. Conclusions: The AquaLase method is safe for ocular tissue. Two years after surgery, most cases of PCO were graded as minimal by both systems of analysis. Not withstanding the slightly better results in eyes with AquaLase polishing of the posterior capsule, this technique was not able to completely prevent a natural progression of PCO.

Use of topical brimonidine to prevent intraocular pressure elevations following Nd: YAG-laser posterior capsulotomy

Objective:To study the effect of brimonidine on intraocular pressure (IOP) following capsulotomy among Indian subjects.Materials and Methods:The study was a nonrandomized trial with open label.Results:80% of the subjects showed a decrease in IOP after instilling 0.2% brimonidine (1 hour pre capsulotomy). No such decrease was observed in control. After 1 and 4 h post capsulotomy a statistically significant decrease in IOP ranging between 1–10 mmHg was found in 73.3% of the treatment group.Conclusions:In the present study 0.2% brimonidine has been proven effective to counteract the increase in IOP following Nd-YAG laser capsulotomy in Indian setting.

COUPLING AGENTS

Objectives: To find out the uses of commercially available clear lubricant eye gel as coupling agent and compare it with 2.5 %methylcellulose in various procedures as 1. In Goldmann triple mirror for gonioscopy 2. In Abraham lens for Nd-YAG laser capsulotomy andiridotomy 3. In Area centralis lens for Grid laser photocoagulation 4. In Wide field lens for scatter or panretinal photocoagulation. S t u dyDesigmProspective Comparative Study. Setting: Diagnostic and research Department of Ophthalmology, Allied Hospital, PMC, Faisalabad.Period:From 1s t July 2008 to 31s t December 2008.Material a n d Patients:Eighty patients, divided into two groups as each group having fortypatients (40 eyes). One drop of topical anesthetic "Alcaine" proparacain hydrochloride was instilled twice in the eye, 5 minutes before startingthe procedure. We used hydroxyprophyl methylcellulose 0.3 % gel in the half of the patients eyes and used traditionally formulatedhydroxypropyl methylcellulose 2.5% in the other half of the patients eyes and the findings were compared with each other. R e s u l t s : 2.5 %methylcellulose was used in 40 eyes during Gonioscopy, Yag-laser iridotomy, Yag-laser capsulotomy and photocoagulation and was comparedwith 0.3 % hydroxypropyl methylcellulose gel in the same procedures in 40 other eyes. Post procedures clarity of view, comfort, irrigation ofsolution remants, redness and stinging sensation were compared with the both coupling agents. The 0.3% gel showed good results.

Proliferation of lens epithelial remnants after Nd-YAG laser capsulotomy

Proliferation of lens epithelial remnants after Nd-YAG laser capsulotomy

The barrier function in neodymium-YAG laser capsulotomy.

Complications following neodymium (Nd)-YAG laser capsulotomy have been attributed to damage to the capsule and vitreous face. To measure the disruption of the anterior-posterior extracapsular barrier complex induced by Nd-YAG laser capsulotomy and to determine how it might be minimized, using a fluorophotometer. Prospective study of 21 eyes undergoing Nd-YAG laser capsulotomy and cross-sectional comparison with 15 pseudophakic eyes with clear capsules. University-based clinical practice. Neodymium-YAG laser posterior capsulotomy per study protocol. Change in extracapsular barrier efficiency as measured by fluorophotometry. Multivariate regression demonstrated that both anterior vitreous disruption and absence of a posterior chamber intraocular lens (aphakia) were significantly correlated with loss of barrier efficiency, whereas capsulotomy size was not. The anterior vitreous was judged to be undamaged in 67% of eyes treated by the study protocol. However, all myopic eyes sustained damage. Opacification of the posterior capsule itself was also associated with mild loss of barrier function even before capsulotomy, compared with the clear-capsule group. Glaucoma occurred more frequently when barrier efficiency was lost postoperatively. Damage to the extracapsular barrier complex by Nd-YAG laser capsulotomy is minimized when the anterior vitreous is preserved. The study treatment protocol may be useful in limiting this damage and in reducing complications.

Massive proliferation of lens epithelial remnants after Nd-YAG laser capsulotomy.

Eight eyes exhibited massive proliferation of lens epithelial remnants following Nd-YAG posterior capsulotomy. All eyes had pre-existing retinal pathology. Six had undergone vitrectomy (four for proliferative diabetic retinopathy) before extracapsular cataract extraction with posterior chamber intraocular lens implantation. The other two eyes had familial exudative vitreoretinopathy or retinopathy of prematurity, respectively. Five eyes required removal of the lens proliferations via a pars plana approach. High levels of growth factors in the posterior segment associated with proliferative disorders of the retina may play a role in lens cell proliferation.