Dorzolamide x Apraclonidine in the prevention of the intraocular pressure spike after Nd : YAG laser posterior capsulotomy

Objective: To determine the frequency of raised intraocular pressure in pseudophakic undergoing Nd YAG laser posterior capsulotomy. To compare the frequency of raised intraocular pressure in pseudophakic undergoing high and low energy Nd YAG laser posterior capsulotomy Methods: This Descriptive case series included 140 patients with pseudophakic posterior capsular opacity. After dilating the pupils with tropicamide Nd YAG laser posterior capsulotomy was performed and the total amount of energy used was noted. The frequency of raised IOP in post-laser patients and comparison of frequencies of raised IOP undergoing high and low energy Nd YAG laser posterior capsulotomies (≤ 50 MJ labeled as low energy and > 50 MJ labeled as high energy) were calculated Results: The mean age was 57.37 ±8.74. Mean pre laser IOP was 15.15 and post-laser IOP was 17.50. The rise in IOP was normal in 82.9% and raised in 17.1%. In lower energy group normal IOP was found in 35.7% and raised in 2.9%. In a higher energy group, normal IOP was found in 47.1%, and raised IOP was found to be 14.3%. Conclusion: Higher the energy used during the Nd YAG laser posterior capsulotomy procedure, more is the chance of a rise in post-laser intraocular pressure as compared to those in which lesser energy was being used.

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FREQUENCY OF ACUTE RISE OF INTRAOCULAR PRESSURE FOLLOWING YAG LASER POSTERIOR CAPSULOTOMY

Gomal Journal of Medical Sciences ◽

10.46903/gjms/16.04.1964 ◽

2018 ◽

Vol 16 (4) ◽

pp. 109-112

Author(s):

Muhammad Adnan Khan ◽

Muhammad Tariq Khan ◽

Ashfaq Ur Rehman ◽

Mohammad Idris ◽

Muhammad Ayub Khan

Keyword(s):

Intraocular Pressure ◽

Cataract Surgery ◽

Goodness Of Fit ◽

Yttrium Aluminum Garnet ◽

Categorical Variables ◽

Posterior Capsular Opacification ◽

Cross Sectional ◽

Yag Laser ◽

Posterior Capsulotomy ◽

Department Of Ophthalmology

Background: Posterior capsular opacification (PCO) is the most frequent complication of cataract surgery. The objective of this study was to determine the frequency of acute rise of intraocular pressure (IOP) following Neodymium-Yttrium Aluminum Garnet (Nd:Yag) laser posterior capsulotomy. Materials & Methods: This cross-sectional study was conducted in the Department of Ophthalmology, HMC, Peshawar, Pakistan, from July-December 2016. Sample size was 325 selected by consecutive sampling technique. Inclusion criteria were all patients having significant PCO after uneventful cataract surgery with intra ocular lens implant. Demographic variables were sex, age groups and age in years. Research variable was presence of acute rise of IOP following Yag laser capsulotomy. Pre-laser assessment included slit lamp examination and recording of IOP with Goldmann applanation tonometer by a single ophthalmologist. IOP was measured 3 hours after Nd: Yag laser capsulotomy. Rise in IOP was labeled when IOP was ≥5 mmhg from baseline. Mean ±SD was used to express quantitative variables like age. Categorical variables were analyzed as frequency and percentage. Goodness-of-fit was applied to compare the frequency of acute rise in IOP between sample and population. SPSS-20 was used for data entry and its analysis. Results: Out of 325 patients, 170(52.3%) were men and 155(47.7%) were women. The mean age of the sample was 44.92 ±23.843 years. A total of 107(32.9%) patients were 20-39 years old whereas 218(67.1%) were 40-70 years. IOP was raised in 61 (18.8%) patients while in 264(81.2%) patients it was not raised. The frequency of acute rise in IOP after Yag laser capsulotomy was significantly different in sample compared to population. Conclusion: Men were more than women, especially of old age. The frequency of acute rise in IOP after Yag laser capsulotomy was significantly different in sample compared to population.

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Ultrasound biomicroscopy evaluation of pseudophakic pupillary block by vitreous prolapse after Nd:YAG laser posterior capsulotomy

Latin American Journal of Ophthalmology ◽

10.25259/lajo_2_2020 ◽

2020 ◽

Vol 3 ◽

pp. 5

Author(s):

Agustín Nicolas Lucas ◽

Agustín Pedalino ◽

Ana Paula Anauati ◽

Clarisa Catalano

Keyword(s):

Intraocular Pressure ◽

Pressure Rise ◽

Corneal Opacity ◽

Ultrasound Biomicroscopy ◽

Common Complication ◽

Yag Laser ◽

Pupillary Block ◽

Posterior Capsulotomy ◽

Intraocular Lens Dislocation ◽

Vitreous Prolapse

Intraocular pressure rise is a common complication after neodymium:yttrium-aluminum-garnet (Nd-YAG) laser posterior capsulotomy. Although in most cases it is related to an inflammatory response, there are other possible mechanisms such as misdirection syndrome and pupillary block. The authors report two cases of pupillary block by vitreous prolapse after Nd-YAG laser posterior capsulotomy evaluated by ultrasound biomicroscopy (UBM). UBM allows to differentiate possible causes of intraocular pressure rising after laser capsulotomy even in cases of corneal opacity. It also allows to detect intraocular lens dislocation, sometimes associated with this situation. This is the first report that describes the characteristics of UBM images of this complication.

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The Effect of 0.25% Apraclonidine in Preventing Intraocular Pressure Elevation after Nd: Yag Laser Posterior Capsulotomy

European Journal of Ophthalmology ◽

10.1177/112067219800800309 ◽

1998 ◽

Vol 8 (3) ◽

pp. 167-172

Author(s):

S. Simsek ◽

H. Ertürk ◽

A. Demirok ◽

A. Cinal ◽

T. Yasar ◽

...

Keyword(s):

Intraocular Pressure ◽

Nd:Yag Laser ◽

Applanation Tonometry ◽

Timolol Maleate ◽

Yag Laser ◽

Posterior Capsulotomy ◽

Group 4 ◽

Group I ◽

Intraocular Pressure Elevation ◽

Group 2

Purpose The efficacy and adverse effects of 0.25% apraclonidine on intraocular pressure (IOP) after Nd: YAG laser posterior capsulotomy were investigated, and the results were compared with placebo, 0.50% timolol maleate and 1% apraclonidine. Methods Eighty eyes were randomly assigned to four groups of 20 eyes. In a double-masked design, the groups were treated with placebo (group I), 0.50% timolol maleate (group 2), 1% apraclonidine (group 3), 0.25% apraclonidine (group 4) one hour before and five minutes after Nd:YAG laser posterior capsulotomy. IOP was measured by applanation tonometry 1 hour before (baseline IOP) and 1,3, 24 hours after capsulotomy. Results The average baseline IOP increased respectively 3.90 ± 5.35, 5.95 ± 5.32, 1.15 ± 3.20 mmHg in the first group 1, 3 and 24 hours post-treatment. There were significant differences between baseline IOP and 1 and 3 hours but not at 24 hours (p=0.004, p=0.001, p=0.13). IOP increased 0.40 ± 4.08, 0.75 ± 5.33, 0.80 ± 6.03 mmHg in the second group at the same times. The differences between the average baseline IOP and the 1, 3 and 24h measurement were not significant (p=0.83, p=0.65, p=0.93). In the third group, IOP decreased 3.70 ± 2.40, 3.30 ± 2.47, 2.65 ± 1.56 mmHg at the measurement times, with significant differences between the average baseline IOP and the 1, 3 and 24 hour measurements (p=0.001, p=0.0001, p=0.01). In the fourth group IOP increased 0.35 ± 3.32 mmHg at 1 hour, but decreased 1.25 ± 3.41, 0.90 ± 2.07 mmHg at 3 and 24 hours. The differences were not significant (p=0.94, p=0.16, p=0.08). When the 0.25% and 1% apraclonidine groups were compared, there were significant differences between the average IOP at 1 hour in both groups but not at 3 and 24 hours (p=0.01, p=0.17, p=0.21). Similarly, there were no significant differences between the average IOP at the same times when the 0.25% apraclonidine group was compared with the timolol group (p=0.30, p=0.08, p=0.16). Some systemic and local side effects were seen in the timolol and 1% apraclonidine groups, but none with 0.25% apraclonidine. Conclusions It was concluded that 0.25% apraclonidine is effective in preventing the early elevation of IOP after Nd:YAG laser posterior capsulotomy and may offer an alternative to 0.50% timolol maleate and 1% apraclonidine.

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