Neodymium–Yttrium-Aluminum-Garnet Laser Lysis of Retained Cortex After Phacoemulsification Cataract Surgery

Hood, Christopher T.; Shtein, Roni M.; Sugar, Alan

doi:10.1016/j.ajo.2012.05.023

Cited by 4 publications

(4 citation statements)

References 18 publications

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“…The incidence of IOP rise was significantly more in the group with higher total energy levels (226 ± 233 mJ). [ 12 ] In a series of 30 patients with PCO, Ari et al evaluated the effect of energy levels for Nd: YAG laser capsulotomy on IOP and macular thickness and found that the severity and duration of IOP rise was less when the total energy was less than 80 mJ. [ 13 14 ] In another study, Karahan et al evaluated the effect of capsulotomy size on IOP and macular thickness.…”

Section: Discussionmentioning

confidence: 99%

Neodymium-yttrium aluminium garnet laser capsulotomy energy levels for posterior capsule opacification

Bhargava

Kumar

Phogat

et al. 2015

J Ophthalmic Vis Res

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Purpose:To study factors affecting laser energy levels required for neodymium: yttrium aluminium garnet (Nd: YAG) laser capsulotomy and to evaluate whether any correlation exists between applied laser energy levels and complications.Methods:The present study examined 474 consecutive patients for a number of factors including age, type of posterior capsule opacification (PCO), material and fixation of intraocular lens (IOL) and complication rates, versus energy levels used for Nd: YAG laser capsulotomy.Results:Mean patient age was 55.6 ± 8.7 years and mean follow up period was 22.9 ± 4.5 months. IOL biomaterial (KW ANOVA; P = 0.173) and patient's age (P = 0.246) did not significantly influence total laser energy requirement for capsulotomy. However, total laser energy levels were significantly higher (KW ANOVA; P < 0.001) with fibro-membranous and fibrous subtypes of PCO. Complications such as IOL pitting, intraocular pressure (IOP) elevation, uveitis, retinal detachment (RD) and cystoid macular edema (CME) were significantly more common when higher energy levels was used. The mean total energy in patients with RD was 77.7 ± 17.7 mJ as compared to 43.4 ± 26.9 mJ in the rest of the cohort. RD was more common in patients with higher axial length [n = 7 (63%)] (P < 0.001).Conclusion:Type of PCO significantly influenced laser energy levels required for capsulotomy, whereas IOL biomaterial and fixation did not. Complications such as IOL pitting, uveitis, IOP elevation, RD and CME was significantly more common when total laser energy was higher. It is recommended that the lowest possible single pulse laser energy be used for capsulotomy to minimize complications.

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Section: Discussionmentioning

confidence: 99%

Neodymium-yttrium aluminium garnet laser capsulotomy energy levels for posterior capsule opacification

Bhargava

Kumar

Phogat

et al. 2015

J Ophthalmic Vis Res

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“…[ 20 , 21 ] Hood et al . [ 22 ] noted a higher increase in IOP in patients with the use of high energy. Both groups of patients had Grade 3 PCO, and the total energy used was 30 mJ.…”

Section: Discussionmentioning

confidence: 99%

The complication rate following Neodymium-doped Yttrium Aluminum Garnet laser posterior capsulotomy for posterior capsular opacification in patients with and without comorbidities

Joshi

Doble

2023

Indian Journal of Ophthalmology

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Purpose: To study the complication rate following Nd: YAG posterior capsulotomy posterior capsular opacification (PCO) in patients with and without comorbid conditions. Methods: This was a prospective, interventional, comparative, and observational study. A total of 80 eyes, consisting of 40 eyes without ocular comorbidities (group A) and 40 eyes with ocular comorbidities (group B) that were being treated with Nd: YAG capsulotomy for PCO, were included. Visual outcome and complications of Nd: YAG capsulotomy were studied. Results: The mean age of group A patients was 61.65 ± 8.85 years and that of group B patients was 63 ± 10.46 years. Of the total, 38 (47.5%) were men and 42 (52.5%) were women. In group B, the ocular comorbidities were moderate nonproliferative diabetic retinopathy (NPDR) (n = 14 eyes; 14/40 = 35%), subluxated intraocular lens (IOL; <2 clock hours of subluxation; n = 6), age-related macular degeneration (ARMD; n = 6), post-uveitic eyes (having old signs of uveitis, no episode of uveitis since the last 1 year; n = 5), and operated cases of traumatic cataract ( n = 4). The mean energy required in groups A and B was 46.95 ± 25.92 and 42.62 ± 21.85 mJ, respectively ( P = 0.422). The average energy requirement in Grade 2, Grade 3, and Grade 4 PCO was 22.30, 41.62, and 79.52 mJ, respectively. An increase in intraocular pressure (IOP) of >5 mmHg from pre-YAG levels was observed in one patient in each group on day 1 postprocedure, for which medical treatment was given to both patients for 7 days. One patient in each group had IOL pitting. No patient had any other complications attributable to ND:YAG capsulotomy. Conclusion: Nd:YAG laser posterior capsulotomy is a safe procedure for PCO in patients with comorbidities. Visual outcomes were excellent after Nd:YAG posterior capsulotomy. Although a transient increase in IOP was noted, the response to treatment was good and a long-term increase in IOP was not observed.

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“…It has been reported that Nd:YAG laser can be used to lyse residual cortex after cataract surgery resulting in an improvement of visual acuity. 8 We attempted this procedure in 1 patient and found a reduction in the amount of cortical matter and improvement in the best corrected visual acuity at 4 weeks post laser. However, a study with larger number of subjects would be needed to validate the findings.…”

Section: Nd:yag Laser Corticolysismentioning

confidence: 94%

A clinical study of anterior segment applications of neodymium-doped: yttrium aluminium garnet laser

Maiya¹,

Ravi²

2018

AOVS

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Background: Nd:YAG laser finds a number of applications in the treatment of anterior segment diseases like primary angle closure and postoperative complications of extracapsular cataract surgery. Aim: To assess the safety and efficacy of Nd:YAG laser in the management of diseases of anterior segment. Methods: This prospective study included patients who underwent Nd:YAG laser therapy for the treatment of anterior segment diseases during a one year period. The nature of procedure, complications during and after laser treatment and outcomes were noted. Patients were followed upto 3 months post treatment. Results: 103 eyes of 75 patients were included. The age of patients ranged from 41-72 years (42 males and 33 females). Nd:YAG laser posterior capsulotomy (n=38) was the most common indication followed by laser peripheral iridotomy (n=30), anterior vitreolysis(n=4), Fibrin membrane lysis (n=2) and corticolysis (n=1). There was an improvement in visual acuity from baseline in patients with posterior capsular opacification and cystoid macular edema due to vitreous-tug syndrome. There was a reduction in the IOP from baseline and widening of the anterior chamber angles following peripheral iridotomy in 89% of the patients with primary angle closure disease. Hyphaema and transient IOP elevation were the most common complications encountered which resolved with therapy. Conclusion: Nd:YAG laser is a safe and effective means of treating the spectrum of primary angle closure disease and complications of extracapsular cataract surgery. It has a better acceptance by patients, is cost-effective, may be performed as an outpatient procedure and avoids complications of surgery.

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Neodymium–Yttrium-Aluminum-Garnet Laser Lysis of Retained Cortex After Phacoemulsification Cataract Surgery

Cited by 4 publications

References 18 publications

Neodymium-yttrium aluminium garnet laser capsulotomy energy levels for posterior capsule opacification

Neodymium-yttrium aluminium garnet laser capsulotomy energy levels for posterior capsule opacification

The complication rate following Neodymium-doped Yttrium Aluminum Garnet laser posterior capsulotomy for posterior capsular opacification in patients with and without comorbidities

A clinical study of anterior segment applications of neodymium-doped: yttrium aluminium garnet laser

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