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Effect of Nd:YAG laser posterior capsulotomy on intraocular pressure, refraction, anterior chamber depth, and macular thickness

Authors Parajuli A, Joshi P, Subedi P, Pradhan C

Received 2 February 2019

Accepted for publication 15 May 2019

Published 6 June 2019 Volume 2019:13 Pages 945—952


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 3

Editor who approved publication: Dr Scott Fraser

Anil Parajuli,1 Purushottam Joshi,2 Prabha Subedi,3 Chandni Pradhan1

1Glaucoma Department; 2Retina Department; 3Cataract and Refractive Surgery, Mechi Eye Hospital, Jhapa, Nepal

Purpose: To see the effect of Nd:YAG laser capsulotomy on intraocular pressure (IOP), refraction, best-corrected visual acuity (BCVA), anterior chamber depth (ACD), and macular thickness.
Methodology: The authors conducted a prospective, descriptive study on pseudophakic eyes with posterior capsule opacification who underwent Nd:YAG laser capsulotomy. BCVA, IOP, spherical equivalent (SE), macular thickness, and ACD were noted preoperatively, at 1 hr postoperatively and at 1-month follow-up. Patients were divided into two groups based on energy used (Group I ≤50 mJ, Group II >50 mJ). None of the patients received prophylactic antiglaucoma medications either before or after the procedure.
Results: There were 96 eyes of 83 patients. Mean total energy levels were 26.64±12.92 mJ in Group I and 81.96±32.10 mJ in Group II. BCVA at 1 hr and 1 month postoperatively improved significantly in both the groups compared to preoperative BCVA (P<0.001). There was no significant change in SE compared to preoperative values in both the groups. The ACD continued to increase significantly in both the groups at both 1 hr and 1-month follow-up. In Group I, IOP increased at 1 hr postoperatively (P=0.023) and declined to preoperative levels at 1 month. In Group II, IOP increased at 1 hr postoperatively (P<0.001) and did not return to preoperative levels at 1-month follow-up (P=0.003). Likewise, macular thickness increased at 1 hr in both groups (P<0.001). In Group I, macular thickness decreased significantly to preoperative level at 1 month whereas in Group II, it remained significantly high at 1-month follow-up (P=0.006). There was no case with serious rise in IOP or cystoid macular edema.
Conclusion: Statistically significant increment in IOP and macular thickness occurs after Nd:YAG laser capsulotomy which however may not necessitate the use of any medications.

Keywords: ACD, IOP, macular thickness, Nd:YAG, PCO, refraction

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