Reopacification of posterior capsular opening after ND: YAG capsulotomy: 2 cases with the different presentation

Purpose: To report the complete opacification of posterior capsulotomy opening after neodymium: yttrium-aluminium-garnet (ND: YAG) posterior capsulotomy for posterior capsular opacification. Methods: A 70-year-old female had uneventful cataract surgery by phacoemulsification technique with implantation of in the bag hydrophilic intraocular lens (IOL) in her left eye. Eight months after surgery, the patient developed posterior capsular opacification (PCO) for which ND: YAG capsulotomy was performed. However, she returned after 7 months first post ND: YAG capsulotomy with the blurring of vision and glare at night. Slit lamp examination revealed pearl like opacification of posterior capsule occupying the YAG capsulotomy opening. A repeated ND: YAG capsulotomy restored her vision to 20/ 20. Another patient operated for posterior polar cataract had dehiscence in the posterior capsule during cataract surgery. The patient was implanted with hydrophobic IOL in the capsular bag without performing an optic capture. The patient presented 3 years later with occlusion of the posterior capsular opening with mixed pearl-like and fibrotic PCO. Conclusion: Occlusion of the posterior capsular opening may occur after ND: YAG capsulotomy and may cause a reduction in visual acuity. Pearl-like opacification is common to occur in reopacification of posterior capsular opening.