Effects of Nd:YAG Laser Posterior Capsulotomy on Intraocular Pressure, Best-Corrected Visual Acuity, and Central Macular Thickness in Posterior Capsular Opacification

Abstract

Background: Posterior capsular opacification (PCO) is a common complication of cataract surgery that can happen weeks to months later and results in decreased vision. Nd:YAG laser capsulotomy is the common treatment for PCO, although it can cause transient changes to the eye.

Objective: To study intraocular pressure, best-corrected visual acuity and central macular thickness after Nd:YAG laser posterior capsulotomy for clinically significant posterior capsular opacification.

Methods: Fifty-eight eyes of fifty-eight participants were included in this prospective observational study. Intraocular pressure (IOP) was measured by Goldmann applanation tonometry, best-corrected visual acuity (BCVA) was measured by Snellen chart and converted to logMAR, and central macular thickness (CMT) was measured by Spectral Domain Optical Coherence Tomography. All assessments were done prior to and at one hour, one week, and one month after capsulotomy.

Results: At baseline, mean IOP was measured at 14.6 ± 2.1 mmHg and at one hour post intervention was measured at 17.3 ± 3.4 mmHg (p < 0.001) with a return to 14.4 ± 2.2 mmHg at the one month follow up. Mean BCVA logMAR improved from 0.64 ± 0.22 to 0.14 ± 0.11 (p < 0.001) with 89.6% achieving 6/12 or better vision. Mean CMT was measured at 242.5 ± 18.4 µm with a statistically significant increase at one week post intervention to 250.7 ± 22.1 µm (p = 0.002) and a return to 243.9 ± 18.8 µm at one month. There was no significant increase in IOP, Cystoid Macular Oedema or other adverse events reported.

Conclusion: Nd:YAG laser posterior capsulotomy significantly improved vision. Post operative changes in IOP and CMT were mild, temporary and resolved by one month.