Changes in macular microvasculature after Nd:YAG laser capsulotomy: an OCT-A study

To investigate microvascular changes in the retina and choriocapillaris using optical coherence tomography angiography (OCT-A) following neodymium:yttrium-aluminium-garnet (Nd:YAG) laser capsulotomy for posterior capsule opacification (PCO), a delayed finding that can be commonly observed after cataract surgery.

Thirty-four eyes of 34 patients undergoing Nd:YAG laser capsulotomy were included. Comprehensive ophthalmologic examination and OCT-A imaging were performed before, one week, and one month after the procedure. Retinal thickness, ganglion cell layer (GCL), retinal nerve fiber layer (RNFL), and vessel densities in the superficial capillary plexus (SCP), deep capillary plexus (DCP), and choriocapillaris (CC) were evaluated.

Following laser treatment, anterior chamber depth (ACD) increased, the foveal avascular zone (FAZ) enlarged, and vessel densities in the central regions of both the SCP and DCP decreased significantly (p = 0.002, p < 0.001, p < 0.001, and p < 0.001, respectively). Additional reductions were also observed in some parafoveal and CC quadrants (Table 4). No statistically significant changes were observed in intraocular pressure (IOP), spherical equivalent (SE), axial length (AL), macular thickness, or choroidal thickness (all p > 0.05).

Our findings indicate that retinal blood flow and vessel density may decrease following Nd:YAG laser capsulotomy; however, the clinical significance of these microvascular changes remains unclear. OCT-A appears to be a promising, non-invasive modality for monitoring retinal microcirculation in patients undergoing this procedure. Nonetheless, further prospective and longitudinal studies are necessary to clarify the long-term consequences and potential functional outcomes of these vascular alterations.