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

Abstract

Background: Posterior capsule opacification is the most common complication of cataract surgery and results from the proliferation and migration of residual lenticular epithelial cells. Opacification may be diminished by atraumatic surgery; complete cleaning of cortex residues, polishing of both anterior and posterior capsules, clinical, pathological and experimental studies have shown that use of hydrodissection, the continuous curvilinear capsulorhexis or the use of specific intraocular lens (IOL) designs. The overall incidence of posterior capsule opacification (PCO) approaches 50% at 5 years following cataract surgery and disproportionately affects younger patients due to higher cell proliferation rates. Capsular-fixated, one-piece all-polymethylmethacrylate PC-IOLs with a Cshaped loop configuration and a posterior convexity of the optic are effective in reducing PCO. Objectives:To evaluate the influence of size and shape of neodymium: yttrium aluminum- Garnet (Nd:YAG) laser capsulotomy on visual acuity and refraction. Patients and method(s): A prospective study was performed in department of ophthalmology at Qena university hospital between September 2016 and September 2017. Informed consent was obtained from each patient before the study. A South Valley University institutional ethics committee approval was obtained. In this study 60 pseudophakic eyes of 58 patients of age range (30-70years) were included. All of the patients had undergone non complicated cataract surgery (phacoemulsification (48eyes) or extracapsular cataract extraction (12 eyes)). Result(s): All patients had significant vision loss and hazy fundus appearance due to posterior capsular opacification. There was significant improvement in VA in the four groups, with statistically significant improvement effect of cruciate shape capsulotomy with size >3.5mm on BCVA. Conclusion:The cruciate 0shape with size more than 3.5 mm capsulotomy openings show better improvement in BCVA than the other groups. Spherical equivalent show slight improvement in all groups which was insignificant.

Keywords

• neodymium-doped; yttrium aluminium garnet; laser capsulotomy