A prospective observational study for the safety of Nd-YAG Laster posterior capsulotomy procedure in patients of Posterior Capsular Opacification (PCO) at the ophthalmology outpatient department of a tertiary care teaching hospital in western India

Abstract

: Nd YAG laser is preferred method to manage thickened posterior capsule because it is an easy, non-invasive and an OPD basis procedure considering the comfort of the patients.: The present study was carried out with objectives to evaluate the safety profile of Nd-YAG Laser Capsulotomy mainly in terms of rise in intraocular pressure (IOP) and other intra as well as post-operative complications.This prospective observational study was carried out with prior Institutional Ethics Committee (IEC) approval and written informed consent from the participants at Ophthalmology Outpatients Department (OPD) of a tertiary care teaching hospital of western India, for the duration of two years from Oct’2015 to Sept’2017. A detailed ocular, systemic, family history was taken of all the enrolled patients with pre- and post-procedure evaluation of IOP by Goldman’s Applanation Tonometry, Slit lamp examination and Fundus examination by direct and indirect ophthalmoscopy. Capsulotomy was done using VISULAS YAG III laser of Zeiss company.The data was entered and tabulated in Microsoft Excel 2007 and analyzed. Data was analyzed by frequency distribution. The ‘p’ value was determined to finally evaluate and P <0.05 was considered as statistically significant.Acute transient rise of IOP up to 5mmHg or more (P value <0.001) was found in Nine cases which is highly significant compared with pre-procedural stage. Intraocular lens pitting was observed in Four cases. Cystoid macular edema was found in one case. Two patients developed mild iritis. Nd-YAG laser capsulotomy is an easy, practical modality to treat posterior capsular opacities, but is not a completely innocuous procedure. Nd-YAG laser capsulotomy is an easy, practical modality to treat posterior capsular opacities, but is not a completely innocuous procedure. Due precautions should be taken in pre- and post-procedural stages including medications, thorough counselling, proper focusing and steady fixation of the patients to minimise the complication.