Varsha Ramesh Dhakne1, Sourabh Hanumant Karad2, Samartha Babasaheb Waghambare3, Hanumant Tulshiram Karad4, Uttam Haribhau Nisale5, Madhuri Tejas Karad6, Rajlaxmi Suhas Pujar7, Harshal Sushil Ambade8
BACKGROUND
Posterior capsule opacification (PCO) is the most common delayed complication of
cataract surgery. Nd:YAG (Neodymium yttrium aluminium garnet) laser posterior
capsulotomy presents the advantages of a non-invasive, effective, relatively safe
technique to manage intact posterior capsule that opacifies postoperatively. With
this background we want to study the visual outcome and complications following
Nd-YAG laser posterior capsulotomy in posterior capsular opacification following
small incision cataract surgery (SICS).
METHODS
The study includes 64 patients attending outpatient department of a tertiary eye
care hospital at Latur from June 2018 to May 2019 who have undergone SICS with
PMMA PC IOL (polymethyl methacrylate posterior chamber intraocular lens)
implantation and clinically diagnosed with posterior capsular opacification. 64 eyes
with PCO were subjected to Nd:YAG laser posterior capsulotomy after detailed slit
lamp bio microscopic examination pre- and post-capsulotomy. Follow-up was done
at 1 hour, 1 week, 2 weeks and 4 weeks and patients were examined for visual
outcome and any complications at each visit.
RESULTS
There were 16 males (25 %) and 48 females (75 %) with a mean age of 65 years.
Posterior capsule opacification occurs within 3 years accounting for 46.9 % of the
cases. Elschnig pearls type of PCO was more common when compared to fibrous
type of PCO. Best corrected visual acuity (BCVA) before Nd:YAG laser capsulotomy
was less than 6 / 60 in 35 patients (54.7 %) and within 6 / 60 to 6 / 24 in 23
patients (35. 9 %) with 6 patients (9.4 %) accounting for visual acuity between 6
/ 24 to 6 / 18. After Nd - YAG Laser Capsulotomy, 46.9 % gained best corrected
visual acuity of 6 / 18 or better, 39.1 % cases improved 6 / 12 and better and
BCVA of 6 / 9, 6 / 6 was observed in 11 cases and 1 case respectively. Only 12
out of 64 patients had complications. Raised intraocular pressure (IOP) was found
in 4 patients. Intraocular lens (IOL) pitting was found in 8 patients.
CONCLUSIONS
Nd:YAG laser capsulotomy is a safe, effective and a non-invasive procedure which
avoids all the complications of surgical capsulotomy in patients of posterior capsule
opacification.
