Variation in Intraocular Pressure and Energy Usage Following Nd:YAG Capsulotomy in Pseudophakic Patients

Abstract

Background: The most frequent late complication of cataract surgery in pseudophakic patients is posterior capsule opacification.

Objective: To assess intraocular pressure changes after Nd: YAG laser capsulotomy and correlate with the total energy applied in pseudophakic eyes.

Materials and Methods: This prospective observational study was conducted in Department of Ophthalmology, People's University of Medical n Health Sciences Nawabshah, Pakistan from November 2025 to April 2026. All 120 pseudophakic patients with posterior capsule opacification that was significant for vision had Nd: YAG laser capsulotomy. Intraocular pressure was measured preoperatively and at 1, 4 and 24 hours postoperatively. The total laser energy used was determined and analyzed.

Results: The mean intraocular pressure increased from 14.3 ± 2.1 mmHg prior to surgery to 17.1 ± 2.8 mmHg at 1 hour and decreased to 14.7 ± 2.2 mmHg at 24 hours. There was a significant correlation between the increase in intraocular pressure after surgery and the laser energy level. There were no major complications in 90.8% of the patients and improvement of visual acuity.

Conclusions: Nd: YAG laser capsulotomy is a safe and effective treatment for posterior capsule opacification. The intraocular pressure elevation is a common event, closely related to the total laser energy, and usually subsides with proper postoperative management.