The effects of Nd:YAG laser posterior capsulotomy on macular thickness, intraocular pressure, and visual acuity

To evaluate how different energy levels of Nd:YAG laser posterior capsulotomy affect best-corrected visual acuity (BCVA), intraocular pressure (IOP), and macular thickness of patients with posterior capsule opacification.

Thirty eyes of 30 patients with posterior capsule opacification following phacoemulsification were enrolled in the study. Patients were classified according to total energy used during Nd:YAG laser capsulotomy (≤ 80 mJ = group I, > 80 mJ = group II).

Mean total energy levels were 58 ± 18 mJ (range: 14 to 80 mJ) in group I and 117 ± 36 mJ (range: 84 to 200 mJ) in group II. BCVA at 1 week preoperatively and 1 and 3 months postoperatively was significantly better compared to preoperative BCVA in both groups (P < .001). In group I, IOP increased 1 week postoperatively (P = .007) and declined to preoperative levels at 1 month. In group II, IOP increased 1 week postoperatively (P = .001) and did not return to preoperative levels during 3 months of follow-up (P = .04). Both groups had increased macular thickness compared to preoperative levels, but group II measurements were significantly higher 1 week and 1 month postoperatively compared to group I (P = .004 and .03, respectively).

Increased IOP and macular thickness are inevitable after Nd:YAG laser capsulotomy, but the severity and duration are less when a total energy level less than 80 mJ is used.