Nd:YAG laser capsulotomy under general anesthesia in the sitting position

Neodymium-yttrium-aluminum-garnet (Nd:YAG) laser capsulotomy is commonly used to treat posterior capsule opacification after cataract surgery in adults. Children and adults with developmental delay, however, are not always cooperative, and the procedure must be performed under general anesthesia. We describe a technique for Nd:YAG capsulotomy under general anesthesia in the sitting position using the standard widely available Nd:YAG laser. Anesthesia was induced in the supine position and the patient was then transferred to the sitting position with chin in the slit-lamp laser delivery system. The procedure was performed without complications. We report our experience in 4 eyes of 3 patients, including 2 children. This technique is a viable option for those without access to an overhead-mounted Nd:YAG laser and an alternative to secondary posterior capsulotomy in selected patients.