Nd: YAG Capsulotomy: Visual Outcomes & Its Associated Factors among Patients with Posterior Capsule Opacification

Abstract

Background: Posterior Capsular Opacification (PCO) is a common post-cataract surgery complication, it is treated by Nd:YAG laser capsulotomy or surgical capsulotomy, nd; YAG laser is a safe, effective, and quick treatment, though it is associated with potential complications. Aim: To assess the visual outcomes of nd; YAG lasers capsulotomy and its associated factors among patients with posterior capsular opacification who attended at KCMC Eye department from July 2023 to May 2024. Methodology: A hospital-based prospective cohort study conducted at KCMC Eye Department, investigated factors affecting visual outcomes after Nd:YAG laser capsulotomy for PCO. Different variables were analyzed, including patient demographics; IOL characteristics, pre- and post- nd; YAG laser VA and IOP, and PCO grade, to determine their impact on best corrected visual acuity one-month post-treatment. Data were cleaned and analyzed using SPSS version 25. Results: This study involved 87 eyes from 87 participants; the average age of the participants was 65 years, ranging from 24 to 90 years. No participant had VA of ≥ 6/12 pre-YAG laser; the majority (48.3%) had VA of 6/60 and below. Post-YAG laser capsulotomy there was a significant change in best corrected visual acuity with (82.7%) attaining good visual acuity from 0% pre Nd: YAG and 17.3% remained with poor visual acuity. There was also a significant change in several lines read on the Snellen chart with the majority 48.3% improving 2 lines post Nd: YAG, only one patient did not improve on the Snellen chart because of macula edema. The improvement in VA was noted among the study participants; however, the changes in VA before and after YAG laser capsulotomy was not statistically significant. In this study, IOP spike, floaters, lens pitting, hyphema, burn IOL, and macular edema were the observed complications. And the presence of factors like, complicated cataracts, high energy setting during the procedure, high-grade PCO, and Sulcus-inserted IOL were associated with poor visual outcome post-procedure. Conclusion: YAG laser capsulotomy is safe, effective and rewarding non-invasive procedure for visual improvement in PCO patients.