Management of the leakage of aqueous humour caused by the wound in a cataract surgery post-operative period with Nd:YAG laser

Abstract

Purpose To describe a new technique for sealing aqueous leakage after cataract surgery using Nd:YAG laser. Introduction The leakage of aqueous humour through the corneal incisions after a surgical procedure still is one of the main complications in the cataract surgery post-operative period. Its cause depends on multiple factors, among which we find the structure of the incision. Several methods to treat its ending have been proposed over the years, and there is not a definitive and standardised method. Although most of the times they are mild and self-limited, in the cases in which the aqueous humour leakage is more profuse, a treatment is needed to avoid the risk of other complications, mainly contaminations that cause infections. Methods The technique consists of generating intrastromal microbubbles with the Nd:YAG laser to increase the pressure against the tunnel, achieving its sealing. It is applied on the corneal stroma, next to the incision plane. Power is set between 1.5 and 2.0 mJ (millijoules), with offset set to 0, and normally between four and six single shots would be sufficient. Results We have achieved the closure in all the patients that we performed this procedure so far. Conclusions We describe an easy and very effective technique for the sealing of the incision with an aqueous humour leakage in the immediate post-operative period of the cataract surgery by using the YAG:Nd laser, allowing a prompt and accessible treatment with a good safety profile, and reducing the need for new procedures and additional check-ups.