Refraction Shift After Nd:YAG Posterior Capsulotomy in Pseudophakic Eyes: A Systematic Review and Meta-analysis

Abstract

PURPOSE: To explore ocular refraction shift after Neodymium: yttrium aluminum garnet (Nd:YAG) posterior capsulotomy in pseudophakic eyes. METHODS: A systematic literature search was performed in the PubMed, Embase, and Cochrane Library databases until November 10, 2021. Studies on the evaluation of changes in spherical equivalent (SE), cylindrical error (CE), or anterior chamber depth (ACD) after Nd:YAG laser capsulotomy were included in the meta-analysis. The review was registered in the international platform of registered systematic review and meta-analysis protocols (INPLASY202120059). RESULTS: A total of 805 eyes from 18 studies were included in the final analysis. The pooled mean differences in SE from baseline to postoperative follow-up points were not significant (1 hour: 0.04 diopters [D], 95% CI: −0.13 to 0.21, P = .644; 1 week: 0.04 D, 95% CI: −0.12 to 0.20, P = .640; 1 month: 0.05 D, 95% CI: −0.06 to 0.16, P = .349). There was no significant difference between baseline CE and any subsequent visit (1 week: 0.14 D, 95% CI: −0.06 to 0.33, P = .172; 1 month: 0.17 D, 95% CI: −0.04 to 0.38, P = .108). No statistical difference in ACD from baseline was observed either (1 hour: 0.01 mm, 95% CI: −0.07 to 0.09, P = .846; 1 week: −0.12 mm, 95% CI: −0.24 to 0.01, P = .079; 1 month: −0.06, 95% CI: −0.14 to 0.01, P = .110). CONCLUSIONS: Neither ocular refraction nor ACD changed within 1 month after laser capsulotomy, suggesting laser capsulotomy did not affect ocular refraction in short-term observation. [ J Refract Surg . 2022;38(7):465–473.]