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- DOI 10.18231/j.ijceo.v.11.i.3.24
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CrossMark
Estimation of mean Nd: yag laser capsulotomy energy level for posterior capsular opacification- Our experience of 76 patients in rural setup
- Author Details:
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Manika Sharma
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Bhawna Chawla
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Kanav Gupta *
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B K Gupta
Manika Sharma
Bhawna Chawla
Kanav Gupta *
B K Gupta
Background: Posterior capsular opacification (PCO), commonly known as "after cataract" or secondary cataract, is a frequent complication following cataract surgery with intraocular lens (IOL) implantation. It occurs when lens epithelial cells proliferate, migrate, and transform into fibroblasts, leading to the formation of an opaque secondary membrane. PCO can cause vision impairment, glare, and monocular diplopia by obstructing or scattering light. Early treatment with Nd:YAG laser capsulotomy has improved outcomes, though complications remain a concern.
Aim: The aim of this study is to determine the Nd:YAG laser capsulotomy energy level in millijoules (mJ), required to achieve a clear visual axis in patients diagnosed with posterior capsule opacification (PCO).
Materials and Methods: The study comprised 76 eyes of patients who had undergone cataract surgery via routine extracapsular cataract extraction (ECCE) or phacoemulsification with intraocular lens implantation. All patients presented with posterior capsule opacification and underwent Nd:YAG capsulotomy at the Department of Ophthalmology, N.C. Medical College, Panipat, between January 2023 and December 2023.
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Results: Out of the 76 eyes treated for posterior capsular opacification (PCO) with Nd:YAG laser, the maximum energy required ranged from 1.2 to 10.0 mJ, with a mean of 2.9 mJ. The range of pulse shots varied from 4 to 34, with a mean of 14, which falls within a safe range, thereby minimizing the rate of complications.
Conclusion: The Nd:YAG laser treatment is indeed an effective method for improving vision hindered by posterior capsular opacification (PCO). However, it's important to note that it's not without complications. Therefore, it's advisable to be mindful of the energy level used during treatment to prevent any potential damage to ocular tissues and minimize the risk of complications.
References
- Wormstone IM. Posterior capsule opacification: a cell biological perspective. Exp Eye Res. 2002;74(3):337–47.
- McDonnell PJ, Zarbin MA, Green WR. Posterior capsule opacification in pseudophakic eyes. Ophthalmology. 1983;90(12):1548–53.
- Khanzada MA, Jatoi SM, Narsani AK, Dabir SA, Gul S. Is the Nd: YAG Laser a safe procedure for posterior capsulotomy? Pak J Ophthalmol. 2008;24(2):73–8.
- Bhatnagar A, Saxena AK and Fahim S. The effects of different techniques and energy used in nd: yag laser posterior capsulotomy on intraocular pressure: a prospective study. Austin J Clin Ophthalmol. 2017;4(1):1–6
- Karahan E, Er D, Kaynak S. An overview of Nd:YAG laser capsulotomy. Med Hypothesis Discov Innov Ophthalmol. 2014;3(2):45–50.
- Aron-Rosa D, Aron JJ, Griesemann M, Thyzel R. Use of the neodymium-YAG laser to open the posterior capsule after lens implant surgery: a preliminary report. J Am Intraocul Implant Soc. 1980;6(4):352–4.
- Gore VS. The study of complications of Nd:YAG laser capsulotomy. International Journal of Bioinformatics Research. 2012;4:265.
- Geerling G, Roider J, Schmidt-Erfurt U, Nahen K, el-Hifnawi ES, Laqua H, et al. Initial clinical experience with the picosecond Nd:YLF laser for intraocular therapeutic applications. Br J Ophthalmol. 1998;82(5):504–9.
- Apple DJ, Peng Q, Visessook N, Werner L, Pandey SK, Escobar- Gomez M, et al. Eradication of posterior capsule opacification: documentation of a marked decrease in Nd:YAG laser posterior capsulotomy rates noted in an analysis of 5416 pseudophakic human eyes obtained postmortem. Ophthalmology. 2001;108(3):505–18.
- Keates RH, Steinert RF, Puliafito CA, Maxwell SK. Long-term follow-up of Nd:YAG laser posterior capsulotomy. J Am Intraocul Implant Soc. 1984 Spring;10(2):164–8.
- Aron-Rosa D, Aron JJ, Griesemann M, Thyzel R. Use of the neodymium-YAG laser to open the posterior capsule after lens implant surgery: a preliminary report. J Am Intraocul Implant Soc. 1980;6(4):352–4.
- Chambless WS. Neodymium: YAG laser posterior capsulotomy results and complications. J Am Intraocul Implant Soc. 1985;11(1):31–2
- Ambler JS, Constable IJ. Retinal detachment following capsulotomy. Aust N Z J Ophthalmol. 1988;16(4):337–41.
- Bath PE, Fankhauser F. Long-term results of Nd:YAG laser posterior capsulotomy with the Swiss laser. J Cataract Refract Surg. 1986;12(2):150–3.
- Billotte C, Berdeaux G. Adverse clinical consequences of neodymium:YAG laser treatment of posterior capsule opacification. J Cataract Refract Surg. 2004;30(10):2064–71.
- Aron-Rosa DS, Aron JJ, Cohn HC. Use of a pulsed picosecond Nd:YAG laser in 6,664 cases. J Am Intraocul Implant Soc. 1984;10(1):35–9. 516 Sharma et al. / Indian Journal of Clinical and Experimental Ophthalmology 2025;11(3):512–516
- Channell MM, Beckman H. Intraocular pressure changes after neodymium-YAG laser posterior capsulotomy. Arch Ophthalmol. 1984;102(7):1024–6.
- Kruger AJ, Schauersberger J, Abela C, Schild G, Amon M. Two year results: sharp versus rounded optic edges on silicone lenses. J Cataract Refract Surg. 2000;26(4):566–70.
- Murrill CA, Stanfield DL, Van Brocklin MD. Capsulotomy. Optom Clin. 1995;4(4):69–83.
- Aslam TM, Devlin H, Dhillon B. Use of Nd: YAG laser capsulotomy. Surv Ophthalmol. 2003;48(6):594–612.
- Auffarth GU, Nimsgern C, Tetz MR, Völcker HE. Analysis of energy levels for Nd: YAG laser capsulotomy in secondary cataract. Ophthalmologe. 2000;97(1):1–4.
- Bhargava R, Kumar P, Prakash A, Chaudhary KP. Estimation of mean ND: Yag laser capsulotomy energy levels for membranous and fibrous posterior capsular opacification. Nepal J Ophthalmol. 2012;4(7):108–113.
- Singh S, Pal V, Dhull CS. A comparative study of PCO in eyes with ECCE. North Zone. J Opthalmol. 2000;12:12–5.
- Awan MT, Khan MA, Al-Khairy S, Malik S. Improvement of visual acuity in diabetic and nondiabetic patients after Nd: YAG laser capsulotomy. Clin Ophthalmol. 2013;7:2011–7.
- Longmuir S, Titler S, Johnson T, Kitzmann A. Nd: YAG laser capsulotomy under general anesthesia in the sitting position. J AAPOS. 2013;17(4):417–9.