Clinical Study on the Intraocular Pressure Changes Following Nd:Yag Laser Capsulotomy.

Abstract

ABSTRACT Background: Posterior capsular opacification (PCO) is the most frequent late postoperative complication following cataract surgery. Currently Nd: YAG laser capsulotomy remains the cornerstone of treatment of PCO. However, it can be associated with significant complications like intraocular pressure rise, intraocular lens pitting, cracking, iritis, vitritis, retinal detachment, cystoid macular edema etc. Raised intraocular pressure is a common complication that occurs after Nd: YAG laser capsulotomy. Aim: To assess the intraocular pressure changes after Nd: YAG laser capsulotomy in patients diagnosed with posterior capsular opacification. Materials and methods: This was a hospital based, prospective follow up study conducted between October 2018 to April 2020.A sample of 50 patients attending the Ophthalmology Out Patient Department at Shri B. M. Patil Medical College and Research Centre diagnosed with visually significant posterior capsule opacification(PCO) after cataract extraction, willing for Nd: YAG laser capsulotomy were selected. Following an informed written consent, selected patients underwent Nd: YAG laser capsulotomy and the number of shots, energy levels were recorded. These patients were further followed up immediately (0 hour),1 hour,2 hours and 1 week post laser for IOP changes, visual acuity improvement and associated complications. DocuSign Envelope ID: 361E56C9C25FD90--21334795--44A4341A--893F0753--DDEFF0DA817ED49E95426CE6 xvi Results: It was observed that post laser, there was a significant rise of mean IOP with increasing time, energy and number of shots and it reduced to baseline or near baseline levels at the end of 1 week. After laser, the best corrected visual acuity(BCVA) at 1 week, was in the range of 6/24p to 6/6. Out of 50 eyes, other complications such as transient iritis occurred in 4% of eyes, IOL pitting and transient vitritis were encountered in 2% cases each. Conclusion: In most of our patients, intraocular pressure returned to baseline or near baseline IOP levels at the end of one week. Hence, regular follow up of all patients is necessary. High skill, apt patient selection, proper focusing of laser, lesser number of shots and minimizing energy levels can reduce the incidence of complications. Thus Nd: YAG laser capsulotomy is a simple, relatively safe, effective and non-invasive treatment modality for PCO.