NZOZ ZBM Zdrowie

Ophthalmology Department Bartosz Wieczorek

Head of the Department Maria Sadowska Wieczorek

Visual outcome and complications

after Nd YAG laser Capsulotomy

in patients with PCO

Introduction:PCO (posterior capsular opacification) is the most frequent consequence of primary cataract extraction,

phacoemulsification with IOL implantation which lead to vision decrease. It occurs in up to 30 % of patients in the term of

two to five years after surgery. Age of patient, type of cataract, type of implanted lens, experience of surgeon, surgery

tools, accompanying diseases are PCO risk factors. The only effective and safe treatment method is Neodymium YAG

laser capsulotomy which cause photodisruption of changed posterior capsule and clear the visual axis.

The aim of the study was evaluation of visual outcome and complications after Nd YAG Light Pulsa 9000 laser

capsulotomy in patients with posterior capsular opacification (PCO) after cataract phacoemulsification in 69 patients

(70 eyes) in 2008.

Purpose:

The study was conducted on 69 patients (70 eyes) admitted to ophthalmology department due to PCO after primary

phacoemulsification. Out of 69 patients 40 was males (57,14%), 39 females (42,86%), the mean age was 67 years old,

the mean term from phacoemulsification was 36,06 months. Laser YAG capsulotomy was conducted on 70 eyes, 31

right eyes (44,28%), 39 left eyes (55,71 %). Fifty two cases (74,25 %) had capsular fibrosis, 18 cases (25,75 % ) had

Elschning pearls. Visual acuity before laser was from 1/50 to 5/50 in 18 eyes (25,71 %), from 5/25 to 5/16 in 32 eyes

(45,71 %)

and 5/10 and more in 20 eyes (28,57 %). Among treated eyes atrophia n. II in 3 eyes (4,28 %), high myopia in 2 eyes

(2,85 %), AMD in 6 eyes (8,57 %) NPDR and ERM in 3 eyes (4,28%) were present.

Different types of laser technique were applied.

Topical NSAIDs drops were applied after the procedure as an inflammation prevention

Methods:

Results:Improvement of visual acuity was present in 67 eyes (95,71 %), in 56 cases (80%) acuity was from 5/7 to 5/5, in 11 cases

(15,71 %) from 5/25 to 5/10. Lack of improvement was observed in 3 eyes (4,28%) due to retinal disease highly advanced

AMD, NPDR.

Post laser lens damage was present in 12 eyes (17,14 %) decrease of IOP in 2 eyes (2,85%) and 1 (1,42%) case of iritis

were observed as post laser complications. There were no other complications ascertained like retinal detachment, lens

dislocation and subluxation, corneal edema or inflammatory process.

Fig.1 Diferent laser technique Fig.2 Elschnig Pearls

YAG laser capsulotomy seems to be the simplest procedure of PCO treatment. It leads to acute vision improvement

in most cases. Frequency of complications is relatively low. It is easy to perform and learning curve is short.

The important thing of prelaser period is individual patients explanation of chance for better visual acuity.

Diseases of posterior segment decrease vision improvement.

Discussion:

Majority of patients had improvement of visual acuity. Described complications did not have significant influence on visual

acuity what verified YAG laser capsulotomy as a safe treatment method of PCO.

Conclusions:

Fig.3 Lens Pitting