Clinical Ophthalmology (Dec 2023)

The Role of Early Nd:YAG Laser Capsulotomy in Improving Visual Performance in Mild to Moderately Symptomatic Trifocal Patients

  • LoBue SA,
  • Martin CR,
  • Benson KK,
  • Trosclair KB,
  • Shelby CL,
  • Coleman III WT

Journal volume & issue
Vol. Volume 17
pp. 3991 – 4000

Abstract

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Stephen A LoBue,1 Curtis R Martin,1 Krysta K Benson,1 Krystle B Trosclair,2 Christopher L Shelby,1 Wyche T Coleman III1 1Department of Ophthalmology, Willis-Knighton Medical Center, Shreveport, LA, USA; 2Department of Graduate Medical Education, Statistics, Willis-Knighton Medical Center, Shreveport, LA, USACorrespondence: Wyche T Coleman III, Department of Ophthalmology, Willis-Knighton Medical Center, Bert Kouns Industrial Loop, Suite 116, Shreveport, LA, 71118, USA, Tel +1-318-212-5901, Email [email protected]: To determine the effect of early Nd:YAG (neodymium:yttrium-aluminum-garnet) laser capsulotomy on objective and subjective visual quality in symptomatic trifocal intraocular lens (IOL) patients.Methods: A single-center, prospective study examined symptomatic patients after bilateral cataract extraction with trifocal IOL implantation. A ten-question survey was conducted one month after surgery. Study endpoints included the assessment of monocular and binocular uncorrected distance visual acuity (UDVA), uncorrected near visual acuity (UNVA), contrast sensitivity (CS), and subjective visual quality before and after Nd:YAG capsulotomy prior to 4 months after cataract surgery.Results: A total of 38 eyes from 21 patients were included with a TFAT00 (n = 23) or TFAT30-60 (n = 15). Overall satisfaction with the IOL was 8.55 ± 1.77 (range 5– 10). A Nd:YAG capsulotomy was performed at 55 ± 26 days. Monocular UDVA and UNVA > 20/25 before Nd:YAG were 53.0% and 42.0%, which improved post-Nd:YAG to 63.0% and 66.0%, respectively (P = 0.41, P = 0.051). Binocular UDVA and UNVA > 20/25 before Nd:YAG were 82.0% and 63.0%, which increased to 97% and 97%, respectively (P < 0.05, P < 0.001). CS increased in all post-Nd:YAG capsulotomies (P < 0.01). The presence of glare was documented at 74% pre-Nd:YAG, which decreased to 41% post-Nd:YAG (P < 0.01). Glare which limited activities was documented at 24%, which decreased to 5% post-Nd:YAG (P = 0.21).Conclusion: Early treatment of posterior capsule opacities in mild to moderately dissatisfied trifocal IOL patients may be beneficial in improving CS, visual quality, and reducing the presence and severity of dysphotopsias.Keywords: trifocal IOL, posterior capsule opacification, Nd:YAG laser capsulotomy, visual performance, dysphotopsias, symptomatic patients

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