Visual outcome and complications following Nd : YAG laser posterior capsulotomy

INTRODUCTION Posterior capsular opacification also known as secondary cataract or after cataract is a late complication of extra capsular cataract extraction or small incision cataract surgery or phacoemulsification with or without intraocular lens implantation. It is one of the most frequent complications of cataract surgery 1 . The higher incidence obtained in young patients is due to an age related effect of fibroblast growth factor on proliferation lens fibers 2 . PCO can also be caused by lens epithelial cells retained in capsular bag following surgery (3). There is gradual deterioration of visual function with decrease visual acuity, decrease contrast sensitivity and glare (4). The PCO develops in months to years postoperatively. Since the use of Nd:YAG Laser for posterior capsulotomy ,the procedure has been replacing surgical capsulotomy as it is less invasive, safe and can be performed as outpatient procedure. *Corresponding author: Shankar Ganvit, Associate Professor Ophthalmology, Department of Ophthalmology, Medical College, Vadodara Email: drshankarganvit@gmail.com Nd:YAG Laser is a photo disruptive laser which produces extreme heat with acoustic shock wave at the site being focused and thus causes disruption of tissue. This property of Nd:YAG Laser is used to disrupt the posterior lens capsule in order to create an opening in it. This causes significant improvement in visual acuity. All though recent modifications in surgical techniques, IOL material and designs have reduced PCO rate, it is still a significant problem following cataract surgery. While doing Nd:YAG Laser capsulotomy some complications are likely to be encountered like rise in intraocular pressure, inflammations in eye and retinal problems like cystoid macular edema. Due to tremendous rise in number of extra capsular cataract extraction (ECCE) with posterior chamber IOL surgeries more and more cases of PCO are coming to our institute for posterior capsulotomy. This prompted us to conduct present study so as to observe document and analyze such events. MATERIALS AND METHODS We conducted a prospective time bound study on 100 eyes of 100 patients after getting approval by Institutional Ethics Committee. Nd:YAG Laser posterior capsulotomy was done ABSTRACT BACKGROUND: Purpose: To find out the immediate visual outcome after performing Nd:YAG laser posterior capsulotomy for PCO and find out various complications after posterior capsulotomy. MATERIALS AND METHODS: After thorough pre laser assessment Nd:YAG laser posterior capsulotomy was performed with APPAYAG laser in 100 eyes of 100 patients. Visual acuity and complications like rise in IOP, aqueous flare and pitting of IOL (intra ocular lens) were noted. RESULTS: Out of 100 patients 51 were male and 49 were female. All patients were pseudophakic and majority of patients were more than 60 years of age and the range was between 5 years to 85 years. Duration of PCO development was earlier in young patients (3 months in 11 to 20 years of age), average duration is 24 months after cataract surgery. All posterior capsulotomies were performed for reduced vision. CONCLUSION: Nd:YAG laser posterior capsulotomy for PCO is universally accepted and rewarding procedure for PCO with good visual outcome. Patients should be carefully followed up and looked for any complications.