EFFECT OF ND: YAG LASER CAPSULOTOMY IN PSEUDOPHAKIC EYES WITH SPECIAL REFERENCE TO IOP CHANGES

CORRESPONDING AUTHOR:
Dr. Shashi Jain,
Anupam Nursing Home,
Behind P.K School,
Rewa-486001,
Madhya Pradesh.
Email: shashimala5@yahoo.com

ABSTRACT: BACKGROUND: Nd: YAG laser is non-invasive and effective means to deal with the posterior capsule opacification. However safe it may have some inherent complications. Rise of intraocular pressure is frequently encountered and incompletely understood complication of YAG laser capsulotomy and documented with conflicting results. AIMS: Purpose of the study to assess the efficacy of YAG laser capsulotomy in term of visual outcome and also study the complications of the procedure, particularly on IOP. SETTING: Tertiary Centre. DESIGN: Prospective interventional study. MATERIAL AND METHODS: Present study evaluate the changes in IOP and visual acuity after Nd-YAG laser capsulotomy in 280 eyes with significant PCO after uncomplicated small incision cataract surgery with IOL implantation. Complete ocular examination including visual acuity, anterior segment examination with slit lamp, fundus and application tonometry were performed pre-and post-laser in all cases. Posterior capsulotomy was done with Q-switched Nd: YAG laser with energy used < 120mJ. IOP was recorded before and then after laser at 1hour, 2 hour, 3 hour, 24 hour and on seventh day in order to determine the IOP changes. STATISTICAL ANALYSIS: The database was collected on a Microsoft Excel (Microsoft Corporation, Redmond, WA) spreadsheet and analyzed using SPSS software 14.0 versions (SPSS, Inc., Chicago, IL). The results were presented in percentages and mean (±SD). The categorical/dichotomous variables were compared using Chi-square/Fisher exact test and continuous variables were compared using unpaired t-test. A P < 0.05 was considered significant. RESULTS: After laser capsulotomy 91% of case showed improvement in visual acuity by more than two lines in Snellen’s vision chart. Transient rise of post laser IOP <5 mm Hg showed in 57% patients within first 2 hours and 33% patients did not developed rise of IOP. Whereas rise of IOP >10 mmHg was found in 5% of cases. Ninety two percent patients achieved base line pressure within 4 hours. Incidence of minor complications was 14.6% and none of patient showed major complications or deterioration of vision. CONCLUSION: Our study showed insignificant rise in IOP, and none of patient show vision threatening complication after laser capsulotomy. Hence routine antiglaucoma medicine may not be necessary in all patients following Nd: YAD laser capsulotomy.

KEYWORDS: Nd: YAG laser, Posterior capsular opacification, Visual acuity, intraocular pressure.