The influence of size and shape of Neodymium-doped:Yttrium Aluminium Garnet (Nd:YAG) laser capsulotomy on visual acuity and refraction

A longitudinal study was carried out in the laser unit of the Combined Military Hospital (CMH), Dhaka on 500 eyes of 500 patients who were treated with Neodymium-yttrium-aluminium-garnet (Nd:YAG) laser capsulotomy over a period of two and a half years. The aim of this study was to evaluate the visual acuity following Nd:YAG laser capsulotomy. The main entry criteria for this study were posterior capsular opacification (PCO) following Extracapsular Cataract Extraction (ECCE). The patients with corneal opacity, glaucoma, vitreous opacity, macular diseases, optic nerve diseases and any other retinopathies causing visual impairment were excluded from this study. Thirty six percent patients had pre-capsulotomy visual acuity 6/36 to 6/60, 32% patients had 6/18 to 6/24, 18% patients had <6/60 and 14% patients had 6/12. After seven days of capsulotomy 76% patients gained 6/12 or better vision. Eighty percent patients gained visual acuity of 6/12 with optical correction after thirty days. On the other hand, 64% patients had pre-capsulotomy near vision < N10 and 16% patients had N8. After capsulotomy near vision improved considerably. Four percent of the patients failed to improve vision following laser capsulotomy. It can be concluded that Nd:YAG laser capsulotomy in PCO can improve both distant and near vision, which can be augmented with optical correction after one month of laser surgery. Key words: Laser capsulotomy, Nd:YAG laser, visual acuity. DOI: 10.3329/jafmc.v5i2.4580 JAFMC Bangladesh Vol.5(2) (December) 2009, pp.29-31

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ND: YAG LASER

The Professional Medical Journal ◽

10.29309/tpmj/18.4743 ◽

2018 ◽

Vol 25 (12) ◽

pp. 1848-1851

Author(s):

Mohammad Alam

Keyword(s):

Visual Acuity ◽

Nd:Yag Laser ◽

Posterior Capsular Opacification ◽

Eye Drops ◽

Slit Lamp ◽

Yag Laser ◽

Corrected Visual Acuity ◽

Nd:Yag Laser Capsulotomy ◽

Department Of Ophthalmology ◽

Best Corrected Visual Acuity

Objectives: To find out the visual acuity outcome after Nd: YAG laser capsulotomy in posterior capsular opacification in pseudophakic patients after cataract surgery. Study Design: Analytical study. Setting: Department of Ophthalmology Khyber Medical University Institute of Medical Sciences / K.D.A Teaching Hospital Kohat. Period: January 2016 to June 2017. Materials and methods: Special proforma was designed for record of patients. PreNd:YAG laser posterior capsulotomy best corrected visual acuity was checked and noted. Anterior and posterior segments examination was done with slit lamp and indirect slit lamp bimicroscopy. Pupils were dilated with tropicamide eye drops. Nd:YAG laser capsulotomy was done. All these procedure were conducted as out door. Patients were put on topical steroid and antiglaucoma drops for ten days to control inflammation and rise in IOP. Post laser best corrected visual acuity was recorded after one month of laser. Results: Total 92 patients were selected with age range from 21 to 83 years. Out of these patients 43(46.74%) were male and 49(53.26%) were female. Post surgical laser period was from 7 months to 13 years. Prelaser best corrected visual acuity of 6/24-6/36 was present in 59(64.13%) patients, 6/60 in 24(26.08%) patients while 9(9.78%) patients had visual acuity of counting finger (CF). Post laser best corrected visual acuity after one month of 6/6-6/9 was recorded in 43(46.39%) patients ,6/12-6/18 in 27(29.34%), 6/24-6/36 in 13(14.13%)and 6/60 & below in 9(9.71%) patients. Conclusion: Post laser best corrected visual acuity is highly improved with Nd:YAG laser capsulotomy in posterior capsular opacification.

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Clinical Study of Visual Outcome and Complications of Nd:YAG Laser Capsulotomy in Posterior Capsular Opacification Following Small Incision Cataract Surgery at a Tertiary Eye Care Centre in Rural Maharashtra - A Prospective Observational Study

Journal of Evidence Based Medicine and Healthcare ◽

10.18410/jebmh/2021/268 ◽

2021 ◽

Vol 8 (19) ◽

pp. 1409-1413

Author(s):

Varsha Ramesh Dhakne ◽

Sourabh Hanumant Karad ◽

Samartha Babasaheb Waghambare ◽

Hanumant Tulshiram Karad ◽

Uttam Haribhau Nisale ◽

...

Keyword(s):

Visual Acuity ◽

Cataract Surgery ◽

Nd:Yag Laser ◽

Visual Outcome ◽

Posterior Capsule Opacification ◽

Posterior Capsule ◽

Posterior Capsular Opacification ◽

Corrected Visual Acuity ◽

Nd:Yag Laser Capsulotomy ◽

Best Corrected Visual Acuity

BACKGROUND Posterior capsule opacification (PCO) is the most common delayed complication of cataract surgery. Nd:YAG (Neodymium yttrium aluminium garnet) laser posterior capsulotomy presents the advantages of a non-invasive, effective, relatively safe technique to manage intact posterior capsule that opacifies postoperatively. With this background we want to study the visual outcome and complications following Nd-YAG laser posterior capsulotomy in posterior capsular opacification following small incision cataract surgery (SICS). METHODS The study includes 64 patients attending outpatient department of a tertiary eye care hospital at Latur from June 2018 to May 2019 who have undergone SICS with PMMA PC IOL (polymethyl methacrylate posterior chamber intraocular lens) implantation and clinically diagnosed with posterior capsular opacification. 64 eyes with PCO were subjected to Nd:YAG laser posterior capsulotomy after detailed slit lamp bio microscopic examination pre- and post-capsulotomy. Follow-up was done at 1 hour, 1 week, 2 weeks and 4 weeks and patients were examined for visual outcome and any complications at each visit. RESULTS There were 16 males (25 %) and 48 females (75 %) with a mean age of 65 years. Posterior capsule opacification occurs within 3 years accounting for 46.9 % of the cases. Elschnig pearls type of PCO was more common when compared to fibrous type of PCO. Best corrected visual acuity (BCVA) before Nd:YAG laser capsulotomy was less than 6 / 60 in 35 patients (54.7 %) and within 6 / 60 to 6 / 24 in 23 patients (35. 9 %) with 6 patients (9.4 %) accounting for visual acuity between 6 / 24 to 6 / 18. After Nd - YAG Laser Capsulotomy, 46.9 % gained best corrected visual acuity of 6 / 18 or better, 39.1 % cases improved 6 / 12 and better and BCVA of 6 / 9, 6 / 6 was observed in 11 cases and 1 case respectively. Only 12 out of 64 patients had complications. Raised intraocular pressure (IOP) was found in 4 patients. Intraocular lens (IOL) pitting was found in 8 patients. CONCLUSIONS Nd:YAG laser capsulotomy is a safe, effective and a non-invasive procedure which avoids all the complications of surgical capsulotomy in patients of posterior capsule opacification. KEYWORDS Posterior capsule opacification (PCO), Nd:Yag Laser Capsulotomy, Best Corrected Visual Acuity (BCVA), Central Subfield Macular Thickness (CSMT)

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A Study of Nd:YAG Laser Capsulotomy in the Management of Posterior Capsular Opacification

MVP Journal of Medical Sciences ◽

10.18311/mvpjms/2016/v3/i1/718 ◽

2016 ◽

Vol 3 (1) ◽

pp. 18

Author(s):

Mrunal Suresh Patil ◽

Dhiraj Namdeo Balwir ◽

Swapnil Vidhate

Keyword(s):

Visual Acuity ◽

Nd:Yag Laser ◽

Visual Outcome ◽

Detailed Examination ◽

Posterior Capsular Opacification ◽

Exclusion Criteria ◽

Posterior Capsulotomy ◽

Transient Rise ◽

Nd:Yag Laser Capsulotomy

Aims: To study the visual outcome following Nd:YAG laser posterior capsulotomy and to study the complications associated with Nd:YAG laser posterior capsulotomy. Material and Methods: The study included a total of 100 eyes of 100 patients who fulfilled the inclusion and exclusion criteria. Once diagnosed to have posterior capsular opacification they were subjected to a detailed clinical examination. All patients underwent Nd:YAG laser capsulotomy. Patients were followed up at 1 hour, 4 hour, 1 day, 1 week, 1 month, 3 month. At every follow up detailed examination was done. BCVA and any complications were noted. Results: Post-laser, 87% patients had BCVA 6/12 or more at 3 month follow up. 10% patients had BCVA 6/24 to 6/18. Only 3% patients had visual acuity improved to less than 6/24. Out of 3 patients, 1 patient had visual acuity improved to 6/60&in remaining 2 visual acuity improved to 6/36. The complications were seen in 31 (31%) patients. Most common complication observed was transient rise in IOP. 17 eyes (17%) had transiently raised IOP. Second most common noted was pitting of IOL. Pitting was present in 7 (7%) patients, 3 (3%) patients had ruptured anterior face of vitreous, 2 (2%) patients had iritis, 1 (1%) had hyphema and 1 (1%) developed CME. IOP rise was related to grade of PCO and energy used. Conclusion: Improvement in visual acuity after Nd:YAG laser posterior capsulotomy is excellent. Complications associated with Nd:YAG laser capsulotomy are minimal. Nd: YAG laser capsulotomy is a safe method of restoring vision in patients with posterior capsule opacification.

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The Effect of Nd:YAG Laser Capsulotomy Size on Refraction and Visual Acuity

Journal of Refractive Surgery ◽

10.3928/1081-597x-20060901-16 ◽

2006 ◽

Vol 22 (7) ◽

pp. 719-721 ◽

Cited By ~ 8

Author(s):

Safiye Yilmaz ◽

Mehmet Ali Ozdil ◽

Naci Bozkir ◽

Ahmet Maden

Keyword(s):

Visual Acuity ◽

Nd:Yag Laser ◽

Nd:Yag Laser Capsulotomy

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CLINICAL ASSESSMENT OF VISUAL ACUITY, REFRACTIVE CHANGES AND IOP FOLLOWING ND:YAG LASER CAPSULOTOMY FOR POSTERIOR CAPSULAR OPACIFICATION

Journal of Evidence Based Medicine and Healthcare ◽

10.18410/jebmh/2018/476 ◽

2018 ◽

Vol 5 (31) ◽

pp. 2302-2308 ◽

Cited By ~ 1

Author(s):

Akash Patil ◽

Vivek Naik

Keyword(s):

Visual Acuity ◽

Clinical Assessment ◽

Nd:Yag Laser ◽

Posterior Capsular Opacification ◽

Nd:Yag Laser Capsulotomy

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Lateral Decubitus Position for Pediatric Nd:YAG Laser Capsulotomy under General Anesthesia

Journal of the Korean Ophthalmological Society ◽

10.3341/jkos.2021.62.7.998 ◽

2021 ◽

Vol 62 (7) ◽

pp. 998-1002

Author(s):

Jung Dong Kim ◽

Hyun Goo Kang ◽

Tae Young Kim ◽

Junwon Lee ◽

Min Kim

Keyword(s):

Visual Acuity ◽

General Anesthesia ◽

Nd:Yag Laser ◽

Vision Loss ◽

Yttrium Aluminum Garnet ◽

Past History ◽

Laser System ◽

Lateral Decubitus Position ◽

Nd:Yag Laser Capsulotomy ◽

Lateral Decubitus

Purpose: To report a successful case of neodymium-doped yttrium aluminum garnet (Nd:YAG) laser capsulotomy performed in a noncompliant pediatric patient using the lateral decubitus position and a conventional slit-lamp-based laser system under general anesthesia.Case summary: Progression of a thick posterior capsular opacity with associated vision loss (best-correct visual acuity of 0.1) was detected in a nine-year-old child with a past history of cataract surgery in his right eye. Diagnosed with pediatric uveitis at the age of five, he had been treated previously using a combination of topical and systemic corticosteroids, which led to the development of the cataract and subsequent surgery 16 months later. Severe photophobia prevented outpatient-based laser treatment, and the patient underwent our modified procedure. Under general anesthesia, the patient was placed in a lateral decubitus position with the use of a long intubation tube. The height of the bed and table-based laser system was adjusted so as to minimize strain when positioning the child’s head. Successful laser capsulotomy was performed within 10 minutes, and the entire anesthesia time was less than 30 minutes. The patient experienced immediate improvement in symptoms, showing a visual acuity of 1.0, which has been sustained as of his most recent visit, 3 months postoperatively. The patient experienced no ocular or anesthesia- related complications. Conclusions: Nd:YAG laser capsulotomy performed by careful positioning (lateral decubitus) under general anesthesia is a viable strategy for the safe and efficient removal of posterior capsular opacities in children with poor compliance.

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Safety and efficacy of Nd:YAG laser capsulotomy in management of posterior capsular opacification

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20190108 ◽

2019 ◽

Vol 6 (1) ◽

pp. 76 ◽

Cited By ~ 1

Author(s):

Pratima Sahu ◽

Amit Kumar Mishra

Keyword(s):

Visual Acuity ◽

Cataract Surgery ◽

Nd:Yag Laser ◽

Tertiary Hospital ◽

Posterior Capsular Opacification ◽

Common Complication ◽

Safety And Efficacy ◽

Nd:Yag Laser Capsulotomy ◽

Defective Vision

Background: At present, the only effective treatment of posterior capsular opacification (PCO), which is the most common complication of modern cataract surgery, is Neodymium-Yttrium Aluminum Garnet (Nd:YAG) laser capsulotomy. There are few complications associated with this easy and quick laser capsulotomy. The current study was conducted in a tertiary hospital of Odisha with an objective to find the safety and efficacy of Nd:YAG laser capsulotomy in the management of defective vision due to posterior capsular opacity.Methods: The study was conducted among the patients attending the Ophthalmology out patient department of a tertiary hospital in Odisha with defective vision due to posterior capsular opacity after cataract surgery. Nd:YAG laser capsulotomy was carried out in all patients with significant PCO. Visual acuity and intraocular pressure were recorded before and after the procedure. The cases were carefully followed up and looked for any complication and visual acuity was assessed during follow up visits.Results: In the study 184 participants were included. Visual improvement was observed in 97.8% participants. Visual acuity improved to 6/6 in 21.73 %, 6/9 in 36.41 % cases, 6/12 in 15.21 % cases. Raised IOP was recorded among 46% of participant after 4 hrs of laser capsulotomy which was later observed among 12% of participants on follow up visit at 1 week. The most common complication recorded was transient rise of IOP (46.3%) followed by aqueous flare (28.8%).Conclusions: Nd:YAG laser capsulotomy is a noninvasive, effective, relatively safe procedure for PCO with good visual outcome.

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Effects Occurring in Central Retina Detected by Optical Coherence Tomography before and after YAG Laser in Pseudophakic Patinets

QJM ◽

10.1093/qjmed/hcaa058.008 ◽

2020 ◽

Vol 113 (Supplement_1) ◽

Author(s):

B Abdala ◽

K Magdy ◽

M M M E Oreiby

Keyword(s):

Visual Acuity ◽

Nd:Yag Laser ◽

Developed Countries ◽

Macular Thickness ◽

Posterior Chamber ◽

Yag Laser ◽

Nd:Yag Laser Capsulotomy ◽

Before And After ◽

Group 2 ◽

Global Initiative

Abstract Introduction Cataract is a consequence of the ageing of the lens and is the major priority in the global initiative to eliminate avoidable blindness by the year 2020. At present, the only means of treating cataract is by surgery, which initially restores high-quality vision and this is currently the most performed operation in developed countries. Aim of the Work to evaluate the influence of Nd:YAG laser capsulotomy on visual outcomes and macular thickness in patients with opacified posterior capsule. Patients and Methods This is a prospective comparative study done at the Nour Elein Hospital in Tanta. Thirty one pseudophakic eyes of patients (seven male, twenty four female), were included in the study with PCO following uncomplicated phacoemulsification with posterior chamber intraocular lens implantation. The age ranged from forty six years to sixty seven years old with a mean of (63.32±5.67) years. An informed consent was taken from each patient. All patients were treated by Nd: YAG laser capsulotomy between January 2017 till December 2017. The average time after cataract surgery was 18 months. Results Both groups had increased macular thickness at 1 week after Nd:YAG laser capsulotomy. The degree of macular thickening was similar in group 1 and group 2. Mean macular thickness was decreased to preoperative levels at 4 weeks after Nd:YAG laser capsulotomy in both groups volume. Conclusion Nd: YAG laser capsulotomy is the standard treatment for PCO and gives rise to rapid improvements in visual acuity, relieving the symptoms of blur, photophobia, and glare, and the size of capsulotomy opening does not affect the improvement in visual acuity, but it is better to avoid small sized capsulotomies to avoid post capsulotomy difractions.

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