scholarly journals Visual Outcome after Nd:YAG Laser Capsulotomy

1970 ◽  
Vol 5 (2) ◽  
pp. 29-31
Author(s):  
MI Hossain ◽  
MA Hossain ◽  
MJ Hossain

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

2021 ◽  
Vol 8 (19) ◽  
pp. 1409-1413
Author(s):  
Varsha Ramesh Dhakne ◽  
Sourabh Hanumant Karad ◽  
Samartha Babasaheb Waghambare ◽  
Hanumant Tulshiram Karad ◽  
Uttam Haribhau Nisale ◽  
...  

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)


2013 ◽  
Vol 1 (1) ◽  
pp. 16-19 ◽  
Author(s):  
Khaleda Nazneen Bari

Background: Neodymium-doped yttrium aluminum garnet (Nd:YAG) laser capsulotomy is a relatively noninvasive procedure that is used in the treatment of posterior capsular opacification (PCO). PCO is caused by proliferation of lens epithelial cells which causes fibrotic changes and wrinkling of the posterior capsule and results in decreased vision, glare, and other symptoms similar to that of the original cataract. Objective: To find out the visual outcome after performing Nd:YAG laser capsulotomy for PCO. Materials and method: A prospective clinical trial was carried out in National Institute of Ophthalmology (NIO), Dhaka, Bangladesh from January 2010 to June 2011 on purposively selected 70 adult subjects of both sexes who developed PCO within 2 months to more than 2 years after extracapsular cataract extraction with posterior chamber intra ocular lens implant. After thorough pre laser assessment Nd:YAG laser capsulotomy was carried out with Zeis VISULAS YAG II through Zeiss slit lamp under topical anesthesia. Data were recorded and expressed as proportion. Results: Out of the 70 subjects 40 were male and 30 were female. The average time interval of cataract surgery and Nd: YAG laser capsulotomy was 23 months. Capsular fibrosis (57.04%) was the predominant type of PCO. The pre laser visual acuity (VA) of more than 61.06% of eyes was 6/36 or below while 41.12% had VA hand movements to finger count. After Nd:YAG laser capsulotomy VA of 6/18 or better was achieved in 63.9% of eyes while 9.94% recovered to 6/9 and 11.36% achieved 6/6. None of these eyes showed further deterioration in VA. Conclusion: Nd:YAG laser capsulotomy for PCO is safe, effective and a rewarding procedure for improvement of vision.DOI: http://dx.doi.org/10.3329/dmcj.v1i1.14971 Delta Med Col J. Jan 2013;1(1):16-19


2016 ◽  
Vol 3 (1) ◽  
pp. 18
Author(s):  
Mrunal Suresh Patil ◽  
Dhiraj Namdeo Balwir ◽  
Swapnil Vidhate

<strong>Aims:</strong> To study the visual outcome following Nd:YAG laser posterior capsulotomy and to study the complications associated with Nd:YAG laser posterior capsulotomy. <strong>Material and Methods:</strong> 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. <strong>Results:</strong> 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&amp;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.<strong> Conclusion:</strong> 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.


2020 ◽  
pp. 173-176
Author(s):  
Kinjal Rathod ◽  
Kinjal Trivedi ◽  
Snehal Nayi ◽  
Somesh Aggarwal

Introduction: Cataract is most common cause of curable blindness worldwide and cataract surgery is most common procedure performed in ophthalmology. Posterior capsular opacification (PCO) is most common complication after cataract surgery which is usually treated with Neodymium-doped: Yttrium Garnet (Nd:YAG) laser posterior capsulotomy or occasionally with a surgical capsulotomy. The incidence and severity of PCO correlates to the type of surgical technique, IOL optic edge designs and IOL materials. Material and Methods: 70 eyes of 64 patients operated for age related cataract were studied in this prospective interventional study. Phacoemulsification was done in 35 eyes and SICS in 35 eyes with hydrophobic single piece biconvex foldable intraocular lens. Patients were followed up at 1, 3, 6, 9 and 12 months for the development of PCO. Clinically significant PCO (loss of 2 or more lines of Snellen’s visual acuity chart) was treated with Nd:YAG laser capsulotomy. Results: The overall incidence of PCO was 22.85%. Amongst the patients who developed PCO, SICS and phacoemulsification was performed in 62.5% and 37.5% patients respectively. Result was statistically significant with p value <0.05 using z test. On first postoperative day, patients operated with phacoemulsification had better visual acuity than SICS. Conclusion: Phacoemulsification can provide early and better visual outcome than SICS and has lower incidence of PCO formation which may be due to difference in irrigation and aspiration and less disruption of blood aqueous barrier than SICS. PCO can be reduced by atraumatic surgery and thorough cortical clean up and capsular polishing.


2018 ◽  
Vol 25 (12) ◽  
pp. 1848-1851
Author(s):  
Mohammad Alam

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.


2019 ◽  
Vol 6 (1) ◽  
pp. 76 ◽  
Author(s):  
Pratima Sahu ◽  
Amit Kumar Mishra

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.


2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Jose Javier Garcia-Medina ◽  
Monica del Rio-Vellosillo ◽  
Vicente Zanon-Moreno ◽  
Enrique Santos-Bueso ◽  
Roberto Gallego-Pinazo ◽  
...  

The visual outcome obtained after cataract removal may progressively decline because of posterior capsular opacification (PCO). This condition can be treated by creating an opening in the posterior lens capsule by Nd:YAG laser capsulotomy. PCO optical imperfections cause several light reflection, refraction, and diffraction phenomena, which may interfere with the functional and structural tests performed in different ocular locations for the diagnosis and follow-up of ocular disease, like macular and optic nerve diseases. Some parameters measured by visual field examinations, scanning laser polarimetry, and optical coherence tomography (OCT) have changed after PCO removal. Imaging quality also changes following capsulotomy. Consequently, the results of ancillary tests in pseudophakic eyes for studying ocular diseases like glaucoma or maculopathies should be correlated with other clinical examinations, for example, slit-lamp biomicroscopy or funduscopy. If PCO is clinically significant, a new baseline should be set for future comparisons following capsulotomy when using automated perimetry and scanning laser polarimetry. To perform OCT in the presence of PCO, reliable examinations (considering signal strength) apparently guarantee that measurements are not influenced by PCO.


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