Intraocular pressure after neodymium:YAG laser treatments in the anterior segment

Intraocular pressure (IOP) increase soon after neodymium:YAG (Nd:YAG) treatments in the anterior segment has been reported. To evaluate this complication in a large sample of patients, we conducted a retrospective study of all Nd:YAG treatments during three years. Three hundred forty capsulotomies and 212 iridotomies were performed with the Q-switched Nd:YAG laser. An IOP elevation of 10 mm Hg or more within two hours of laser surgery was seen in 15 eyes (4.4%) that had a capsulotomy but in 45 eyes (21.2%) that had an iridotomy. In 13 of the 15 eyes in which the IOP increased after capsulotomy, additional risk factors (glaucoma, high myopia, aphakia) were found. Our results indicate that posterior capsulotomy with the Nd:YAG laser in otherwise healthy, pseudophakic eyes is usually not accompanied by immediate IOP elevation. Elevation can be predicted by risk factors and therefore anticipated in a small group of vulnerable patients.