O R I G I N A L R E S E A R C H Nd: YAG capsulotomy for posterior capsule opaciﬁcation after combined clear corneal phacoemulsiﬁcation and vitrectomy Ilias Georgalas1 Petros Petrou2 George Kalantzis2 Dimitrios Papaconstantinou2 Chr ysanthi Koutsandrea2 Ioannis Ladas2 1Department of Ophthalmology, “G. Gennimatas” Hospital of Athens, NHS, Athens, Greece; 2Department of Ophthalmology, University of Athens, Athens, Greece Correspondence: Ilias Georgalas Consultant Vitreoretinal Surgeon, 59 Chrysanthemon Str, 15452 Athens, Greece Tel +30 21 0776 8374 Fax +30 21 0776 8374 Email igeorgalas@yahoo.com Purpose: To evaluate the efﬁcacy and safety of Neodymium:YAG (Nd:YAG) laser capsulotomy for posterior capsule opaciﬁcation (PCO) following combined phacoemulsiﬁcation and vitrectomy for the treatment of cataract in association with macular hole (MH) or epiretinal membrane (ERM). Methods: Retrospective clinical study of 34 eyes of 34 patients who underwent combined cataract surgery and vitrectomy, developed PCO, and subsequently underwent Nd:YAG laser capsulotomy. Follow-up examinations included visual acuity measurement, evaluation of intraocular lens (IOL) centration, intraocular pressure (IOP) measurement, and dilated fundus examination. Results: Nd:YAG laser capsulotomy was performed in all 34 eyes. The mean age of the patients was 65.08 years (range 45–87) and the mean follow up period was 11.05 months (range 4–23). The mean time elapsed between the last intraocular operation and the development of PCO was 10.00 months for patients with previous ERM and 15.33 for those with MH (P = 0.001, t-test for equality of means). None of our patients developed recurrence of MH, retinal detachment, IOL dislocation, or permanent IOP elevation. Conclusion: In our study, the most remarkable observation is that no complication occurred after the YAG capsulotomy, possibly because the eyes were vitrectomized and vitreous seems to play an important role in the occurrence of post-Nd:YAG complications. In addition we noted that PCO seems to occur earlier in the eyes undergoing combined surgery for cataract and ERM when compared with those where combined phacoemulsiﬁcation and vitrectomy are performed for cataract and MH. Keywords: Nd:YAG capsulotomy, phacoemulsiﬁcation, vitrectomy Introduction Cataract, epiretinal membranes (ERM), and macular holes (MH) are distinct clinical entities frequently coexisting in the same patient. Robert Machemer, who was the ﬁrst to establish an experimental model of retinal detachment, is best known for his development of pars plana vitrectomy for the treatment of vitreous hemorrhages in proliferative diabetic retinopathy.1 Nowadays, almost four decades since Machemer’s revolutionary work, performance of combined vitrectomy and phacoemulsiﬁcation is common when both cataract and vitreoretinal disease are present. This approach is necessary to enable adequate visualization of the posterior pole during vitreoretinal procedures and even if the opaque lens does not reduce visual function prior to surgery, it often progresses postoperatively as a result of vitreoretinal operation and the use of intraocular gas or silicone oil. Additionally, combined surgery has been considered to reduce intraoperative complication rates and allows immediate visual rehabilitation with only one operation.2–4 Therapeutics and Clinical Risk Management 2009:5 133–137 © 2009 Georgalas et al, publisher and licensee Dove Medical Press Ltd.This is an Open Access article which permits unrestricted noncommercial use, provided the original work is properly cited. 133