YAG Laser Posterior Capsulotomy Research Articles

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.

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.

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.

Harmonizing ophthalmic residency surgical training across Europe: A proposed surgical curriculum.

One of the core aims of the European Union of Medical Specialists is to harmonize training across Europe by creating European Training Requirements for all medical specialties including Ophthalmology. The theoretical part is already defined by the EBO, however as ophthalmology also includes surgical skills, we herein propose a surgical minimum curriculum for ophthalmology residents in Europe. National and international ophthalmic training curricula which are publicly available in English were reviewed and compared. The final proposal was created from 5 criteria: 1. Disease prevalence; 2. Patient safety; 3. Case-trainee ratio; 4. Skill transfer; and 5. Technical difficulty. In total 7 different training curricula from across the world were compared. Among the surgical procedures, cataract surgery has the highest median number of procedures required to be completed during residency: 86 procedures (50-350). Followed by oculoplastics: 28 procedures (10-40) and panretinal photocoagulation: 27.5 procedures (10-49) Full procedural competence is proposed in 9 surgical skills, including YAG laser posterior capsulotomy, retinal argon laser, intravitreal injection, corneal foreign body removal, removal of corneal sutures, facial and periocular laceration repair, eyelid laceration repair, minor eyelid procedures, and punctal occlusion. These procedures are deemed essential and feasible for all ophthalmology residents in Europe to perform independently upon completion of their training. This proposal should be regarded as a recommendation based on comparable surgical curricula in use worldwide to establish standards across European countries and may serve as valuable insight to those responsible for compiling ETRs for ophthalmology, or their national curriculums.

The outcomes of cataract surgery in eyes with Fuchs uveitis

BackgroundTo evaluate clinical results in eyes undergoing phacoemulsification intraocular lens (IOL) implantation due to Fuchs, uveitis (FU) related complicated cataract.MethodsPost-surgical outcomes of 56 eyes of 55 FU patients were evaluated retrospectively. Three groups were formed according to the IOL model: hydrophilic SAF6125 (Optima fold) acrylic, hydrophobic SN60AT (Alcon), and hydrophobic AAB00 (Abbott). Postoperative posterior capsular opacification (PCO) development and PCO development time, neodymium number: YAG laser posterior capsulotomy rate, giant cell (GC) deposition on the IOL, and the development time of GC deposits were compared among the groups. All patients were followed postoperatively on the 1st day, 1st week, 2nd and 6th weeks, and then at 3-month intervals.ResultsThe hydrophilic SAF6125 IOL was implanted in 10 eyes, hydrophobic SN60AT in 24 eyes and AAB00 IOL in 22 eyes. The mean postoperative follow-up time was 34.1 ± 30.1 (6-144) months. PCO developed in 7 eyes (70%) in the hydrophilic SAF6125 group, 17 eyes (70.8%) in the hydrophobic SN60AT and 13 eyes (59.1%) in the AAB00 group. There was no statistically significant difference among the three IOL groups in the PCO development, the PCO development time and YAG laser capsulotomy rates (P = 0.674, P = 0.111, and P = 0.507, respectively). The PCO development time was significantly longer in the hydrophobic SN60AT than AAB00 group (P = 0.027). GC deposits were detected in 3 eyes (30%) in the hydrophilic SAF6125 group, 7 eyes (29.1%) in the hydrophobic SN60AT and 3 eyes (13.6%) in the AAB00 group. GC deposition and the development time of GC deposits were similar among the three IOL groups (P = 0.575, P = 0.804). At the final follow-up, BCVA was ≥ 20/40 in 41 eyes (73.2%).ConclusionThe GC deposits and PCO development were the most important problems in these eyes with hydrophilic or hydrophobic IOLs despite good visual and postoperative results. New developments are needed in terms of IOL design or content in eyes with FU.

Analysis of influencing factors associated with the time between cataract surgery and Nd:YAG laser posterior capsulotomy.

To retrospectively analyze the clinical data of large samples of YAG laser posterior capsulotomy, and to explore the influencing factors of time from cataract surgery to YAG laser capsulotomy (TFCSTLC), so as to provide reference for the occurrence and treatment of real-world posterior capsular opacification (PCO). 1093 patients (1093 eyes) with PCO who underwent YAG laser posterior capsulotomy from 2014 to 2019 in the largest eye center of northwest China were analyzed retrospectively. The gender, age, systemic complications, material, and design of intraocular lens (IOL) and TFCSTLC were recorded. The test and Wilcoxon rank sum test were applied to analyze and compare the average TFCSTLC values under different factors, and the relationship between each factor and TFCSTLC was analyzed by multiple linear regression. The average TFCSTLC was 19.2 (range, 7.9 ∼ 31.2) months. There were significant statistical differences in TFCSTLC among the implanted single focus versus multifocal IOLs (P < 0.001), diabetic versus non-diabetic patients (P < 0.001), high myopia versus non-high myopia patients (P = 0.003). Multiple linear regression analysis demonstrated that TFCSTLC was negatively correlated in patients with diabetes mellitus versus with no history of diabetes mellitus (coefficient, -5.36; 95% confidence interval [CI], -8.30 to -2.41; P < 0 .001), and multifocal IOL versus a single focus IOL implanted (coefficient, -5.56 ; 95% CI, -9.01 to -2.11; P = 0.002). TFCSTLC may be affected by many factors in the real world. The YAG laser posterior capsulotomy time was sooner in patients with a history of diabetes mellitus and multifocal IOL implanted.

Scheimpflug Imaging of Late-onset Capsular Bag Distention Syndrome Treated with Nd: YAG Laser: A Case Report

Aims: To report a case of very late-onset capsular bag distention syndrome (CBDS) 8 years after uncomplicated cataract surgery treated with Neodymium: Yag (Nd: Yag) laser posterior capsulotomy.&#x0D; Presentation of the Case: A 76-year-old female patient without any systemic or ocular disorders, presented with progressive blurry vision in her right eye (RE) over the last 1 year. Best-corrected visual acuity (BCVA) was 6/9 in the right eye and 6/6 in the left eye. Manifest refraction revealed a 0.5 diopters myopic shift in her RE compared to her last ocular examination 2 years ago. Scheimpflug photograpgy and slit-lamp examination were utilized to make the diagnosis of CBDS, which was successfully treated with Nd: Yag laser posterior capsulotomy. At day 1 post-capsulotomy the BCVA of her RE improved to 6/6 with a 0.5 diopters hyperopic shift which was consistent with a 0.13 mm post-capsulotomy increase in the anterior chamber depth, as documented by the Scheimpflug images.&#x0D; Discussion and Conclusion: Late-onset CBDS can manifest after a considerable time period following cataract surgery and Scheimpflug imaging can be a useful aid for a precise diagnosis and documentation of the treatment.

ESTIMATION OF VISUAL OUTCOME, COMPLICATIONS AFTER ND – YAG CAPSULOTOMY

Aims And Objectives:To analyse the clinical outcomes of Nd: YAG laser posterior capsulotomy. It is a cross sectional prospective interventional study. 1. To assess the visual outcome following posterior capsulotomy with Nd: YAG laser for posterior capsular opacication. 2. To study Intraocular pressure (IOP) changes after posterior capsulotomy with Nd: YAG laser. 3.To study other post -procedural Nd: YAG laser capsulotomy complications. Materials And Methods: A Cross-sectional prospective interventional study was conducted in the Department of Ophthalmology, Rangaraya medical college, Kakinada on 75 patients over the age of 16 who had clinically detected posterior capsule opacication following cataract extraction. Study tools: Snellen's visual acuity chart, Slit lamp biomicroscope, Direct ophthalmoscope, Indirect ophthalmoscope- +90D biomicroscope, Schiotz / Applanation tonometer Results Signicant visual improvement was seen in 96% patients. Conclusion: The results of the present study show that posterior capsulatomy with a Nd: YAG Laser is effective and safe method to improve vision.

The Royal College of Ophthalmologists' National Ophthalmology Database study of cataract surgery: Report 9, Risk factors for posterior capsule opacification.

Posterior Capsule Opacification (PCO) is the most common long-term post-operative adverse occurrence after cataract surgery often requiring treatment with YAG laser posterior capsulotomy. This study aimed to identify potential risk factors, known at the time of cataract surgery, that influence the development of PCO. A retrospective study of publicly funded cataract surgery from The Royal College of Ophthalmologists' National Ophthalmology Database. Eligible for analysis were 500,872 cataract operations performed in 41 participating centres. The 500,872 operations were performed on 243,167 (48.5%) left eyes and 257,705 (51.5%) right eyes from 373,579 patients by 2196 surgeons. Post-cataract PCO was recorded for 61,778 (12.3%) eyes and the six month, one, three, five and nine year observed rates of PCO were 2.3%, 4.4%, 19.7%, 34.0% and 46.9% respectively. Different PCO profiles were observed between IOL materials and the identified risk factors that increased the risk of developing PCO included hydrophilic IOL material, axial length >26 mm, the presence of high myopia and implantation of lower IOL powers and previous vitrectomy surgery, along with younger age and female gender. Many factors influence the development of PCO relating to the patient, the eye, the lens and the surgery. Some factors are modifiable such as IOL material, therefore the opportunity exists to attempt to reduce PCO rates, benefitting patients and the UK NHS.

Evidence-Based Point-of-Sale Policies to Reduce Youth Tobacco Use in North Carolina.

Many states and localities in the United States are implementing evidence-based tobacco control policies at the retail level, including Tobacco 21 laws, tobacco retailer licensing, restrictions on point-of-sale promotions, and bans on flavored tobacco products. With the passage of new point-of-sale tobacco control policies, North Carolina could reduce youth tobacco use rates.

Intraocular Pressure and its Variation with Total Amount of Energy used Following Nd: YAG Capsulotomy in Pseudophakic

Purpose: The objective of the study was how Nd: YAG laser capsulotomy affected IOP and how it changed with the amount of energy utilised. Methods: A prospective, multi ccentered study was conducted between September 2021 to February 2022 in Ophthalmology Department departments. Total of sixty pseudophakic eyes of both genders, age ranging between 40 to 60 years with significant posterior capsular opacity following uncomplicated cataract surgery were included through non-probability purposive sampling technique. Inflammation, ocular malignancies, posterior segment disease, and systemic disease participants were all ruled excluded. After detailed history and ocular examination, Nd: YAG laser posterior capsulotomy was done. Patients were divided into two groups on the basis of total amount of laser energy used was noted as high energy (&gt;50mJ) and low energy (&lt;50mJ) and then post-laser IOP after one hour and 24 hours measured. Data was analyzed by using SPSS through repeated measure ANOVA for comparison of quantitative variables. Results: Best corrected visual acuity after Nd: YAG capsulotomy improved significantly (P=0.001). Pre-laser IOP was 14.01± 2.95 mmHg. Mean high energy was 76mJ and low energy 40mJ. Elevated IOP was seen in 55 patients, significantly increase in IOP after 1 hour in both groups (P=0.000). After 24hours IOP change was significantly higher in high energy group (p=0.033) than in low energy. Post-laser IOP after 1 hour in high energy group was 21.89±4.59 mmHg and in low energy group 16.79±2.89 mmHg. IOP after 24hour in high energy group was 19.89± 3.05 mmHg and in low energy group 14.98±1.79 mmHg. Conclusions: After Nd: YAG laser capsulotomy, there is a considerable increase in IOP, which varies depending on the overall amount of energy used. Greater the amount of Nd-YAG energy has significantly higher chances of raising IOP. Hence, it was suggested that each patient after Nd: YAG capsulotomy must monitored for IOP variation. Keywords: Intraocular pressure, Nd: YAG capsulotomy, Energy level, Posterior capsular opacity, Visual acuity

Phacoemulsification Combined With Supra-Capsular and Scleral-Fixated Intraocular Lens Implantation in Microspherophakia: A Retrospective Comparative Study.

BackgroundMicrospherophakia (MSP) is a rare ocular condition, the lens surgery of which is complicated by both insufficient zonules and undersized capsule.MethodsThis study included MSP eyes managed with phacoemulsification combined with supra-capsular and scleral-fixated intraocular lens implantation (SCSF-IOL) and made the comparison with those treated by transscleral-fixated modified capsular tension ring and in-the-bag intraocular lens implantation (MCTR-IOL).ResultsA total of 20 MSP patients underwent SCSF-IOL, and 17 patients received MCTR-IOL. The postoperative best corrected visual acuity was significantly improved in both groups (P < 0.001), but no difference was found between the groups (P = 0.326). The IOL tilt was also comparable (P = 0.216). Prophylactic Nd:YAG laser posterior capsulotomy was performed 1 week to 1 month after the SCSF-IOL procedure. In the SCSF-IOL group, two eyes (10.00%) needed repeated laser treatment and one eye (5.00%) had a decentered capsule opening. Posterior capsule opacification was the most common complication (6, 35.29%) in the MCTR group. No IOL dislocation, secondary glaucoma, or retinal detachment was observed during follow-up.ConclusionsSCSF-IOL is a viable option for managing MSP and is comparable with the MCTR-IOL. Nd:YAG laser posterior capsulotomy was necessary to prevent residual capsule complications after the SCSF-IOL procedure.