Long Term Safety and efficacy of Nd: YAG Capsulotomy for Posterior Capsule Opacification!

To evaluate long term safety and efficacy of Nd: YAG laser capsulotomy in various subtypes of Posterior capsule opacification (Membranous, Fibrous, Fibro-membranous) after uneventful cataract surgery, over a post -operative period of up to three years.

The prospective study included 235 cohorts with visually significant PCO, who underwent Nd: YAG laser capsulotomy following uneventful cataract surgery, after a quite post-operative period of 3 months. Patients were followed-up on first, third and seventh postoperative days, then weekly for two weeks, monthly for two months and every three months thereafter. On each follow up visit, Best corrected visual acuity (BCVA), Applanation tonometry, and Slit-lamp bio microscopic examination with +90D Lens and Indirect Ophthalmoscopy was performed.

The statistic mean age was 60.4372. The range was (45–83). The mean interval between surgery and PCO formation was 12 months. The statistic mean follow up period was 30.130 months. Transient IOP elevation, Iritis, Vitreous prolapse and Retinal detachment, IOL pitting were the most commonly noted complications respectively. Frequency of Retinal detachment was 4.18% (Table 1). The statistic mean period after Nd: YAG Laser capsulotomy and diagnosis of retinal detachment was 12.7 months.

Nd: YAG laser capsulotomy compromises on the integrity of posterior capsule and may be associated with vision threatening posterior segment complications like Cystoid Macular oedema and Retinal Detachment. There appears to be some correlation between amount of laser energy used and complications like IOP elevation and Iritis, however, it cannot be said whether any direct correlation exists between retinal detachment and extent of laser energy used. We need to be cautious in doing capsulotomies in patients with pre-existing retinal diseases. Therefore, it is best advised to limit the amount of laser energy delivered to the eye to prevent complications.