Refractive Changes after Nd.YAG Laser Capsulotomy in Pseudophakic Patients

Abstract

Postoperative cataract surgery often results in posterior capsule opacification (PCO), causing low visual acuity and uniocular diplopia. Factors include patient age, lens type, surgery technique, and diseases. YAG capsulotomies, a noninvasive procedure, can cause complications like pressure elevation, IOL damage, inflammation, and retinal detachment. The study aims to evaluate the effect of Nd: YAG laser posterior capsulotomy on a patient`s refractive status. This study was conducted at Benghazi Teaching Eye Hospital in Libya. The sample consisted of patients who had anterior capsulorrhexis during cataract surgery and had anterior capsulotomies. Patients were selected based on their condition and underwent a comprehensive eye examination, including refraction, unaided visual acuity, and best-corrected visual acuity. Postoperatively, posterior capsulotomies were performed using a Nd: YAG laser. The surgical techniques involved administering a single shot of Nd: YAG laser, administering topical anesthetic agents, clearing the central posterior capsule, and applying energy levels. The mean age of 63.45 + 7.69 years, with a majority being female (63.6%) and (60.6%) right side eye. The procedure significantly impacted the participants' visual acuity(P<0.001), with changes in sphere, cylinder, and spherical equivalent measurements (<0.001). A one-month follow-up showed significant improvement in visual acuity, with a trend towards better refractive outcomes. The stability of the cylinder axis suggests a consistent correction of astigmatism post-operatively. The results demonstrate positive long-term outcomes in this study. With the average centroid being 0.52D at 26°±1.31D and 0.65D at 27°±1.23D at one month. The study found that individuals who underwent Nd: YAG posterior capsulotomy had better vision, with refraction changes frequently leading to a hyperopic shift.