Refractive changes following yttrium aluminum garnet laser capsulotomy in pseudophakic patients

Abstract

Purpose To study the effect of neodymium-doped yttrium aluminum garnet (Nd : YAG) laser posterior capsulotomy on refraction and best-corrected visual acuity in pseudophakic eyes. Patients and methods This retrospective nonrandomized analytic study included 110 eyes (n=100 patients) with posterior capsular opacification following a phacoemulsification with foldable hydrophobic intraocular lens implantation surgery. Thorough ophthalmological examinations were performed for all subjects before and after YAG capsulotomy. The best-corrected visual acuity, refractive sphere, and refractive cylinder calculations before and one month after the capsulotomy were recorded. Results Patients’ mean±SD age at the time of surgery was 61.35±14.46 years. The mean±SD refractive sphere changed toward a myopic shift from 0.04±1.78 before capsulotomy to −0.40±1.43 after capsulotomy. The mean±SD refractive cylinder was −1.67±1.45 before capsulotomy and changed to −1.42±1.16 after capsulotomy, making a mild hyperopic shift. Changes in the axis of the cylinder were not statistically significant. A significant improvement was seen in the best-corrected visual acuity from 0.49±0.33 before capsulotomy to 0.23±0.22 after capsulotomy (P<0.001). Conclusion Visual acuity (best-corrected visual acuity) was significantly enhanced following the Nd : YAG laser capsulotomy, and therefore, it is suggested that Nd : YAG laser capsulotomy is a safe and effective alternative treatment for posterior capsular opacification. There are significant changes in the refractive sphere toward a myopic shift following the YAG laser capsulotomy and a significant change in the refractive cylinder toward a hyperopic shift, whereas there were no significant changes in the cylinder axis.

Keywords

• neodymium-doped yttrium aluminum garnet laser
• posterior capsulotomy
• pseudophakia
• refractive cylinder
• refractive sphere