Effect of Nd:Yag Laser Posterior Capsulotomy on Intraocular Pressure, Refraction, Anterior Chamber Depth, Macular Thickness, and Spherical Equivalent in Patients with Posterior Capsular Opacification: a Prospective Interventional Study

Abstract

Background: Posterior capsular opacification is the most common late complication of cataract surgery and a major cause of visual deterioration after successful cataract extraction. Nd:YAG laser posterior capsulotomy is the standard treatment for visually significant posterior capsular opacification; however, it may influence intraocular pressure, refraction, anterior chamber depth, and macular thickness. This study evaluated the effect of Nd:YAG laser posterior capsulotomy on these ocular parameters.

Methods : A prospective interventional study was conducted in the Department of Ophthalmology, Jawaharlal Nehru Medical College, Ajmer, Rajasthan, from June 2024 to May 2025. One hundred patients with visually significant posterior capsular opacification underwent Nd:YAG laser posterior capsulotomy. Best corrected visual acuity, spherical equivalent, influence intraocular pressure, anterior chamber depth, and macular thickness were assessed before treatment and at 1 hour, 1 week, and 1 month post-procedure. Statistical analysis was performed using paired t-tests, with p<0.05 considered significant.

Results: The mean age of participants was 67.37 ± 16.05 years, and 62% were female. Visual acuity improved significantly after capsulotomy, with all patients achieving best corrected visual acuity of 6/6 at one month. Mean spherical equivalent changed from −0.27 ± 0.279 D to −0.195 ± 0.272 D at one week (p=0.040) and remained stable thereafter. Mean influence intraocular pressure increased significantly from 14.6 ± 2.01 mmHg to 17.0 ± 1.95 mmHg at 1 hour (p<0.001), followed by gradual reduction. Anterior chamber depth and macular thickness showed transient postoperative increases and approached baseline values during follow-up.

Conclusion: Nd:YAG laser posterior capsulotomy is a safe and effective treatment for posterior capsular opacification, providing excellent visual rehabilitation with only transient changes in influence intraocular pressure, refractive status, anterior chamber depth, and macular thickness.