Abstract

Introduction: The most common complication of cataract surgery is a secondary posterior capsule opacification (PCO). Its incidence is estimated at 37% in patients over 40 years of age. Nd-Yag laser capsulotomy is the treatment of choice for PCO but is known to be associated with complications such as increased intraocular pressure (IOP), cystoid macular edema, retinal detachment and corneal burns. The most common complication is increased IOP.Aim: The aim of this study is to evaluate the changes in intraocular pressure (IOP) after Nd-Yag laser posterior capsulotomy (LPC) for PCO.Patients and Methods: This is a longitudinal study in patients treated with posterior Nd-yag laser capsulotomy for secondary posterior capsule opacification in Hassan II hospital University of fez/Morocco. The inclusion criteria are: Patients older than 10 years, tonometry on the fellow (control) eye is possible, No history of glaucoma and endocular surgery, clear cornea, No pre-existing uveitis, IOP before Nd yag LPC is between 8 mmHg and 21 mmHg. IOP was checked before laser, at one hour, 24 hours, one week, one month and three months after laser. The T student test is performed for statistical study; whose values are considered significant when the p is less than 0.05.Results: A total of 32 eyes from 30 patients were included in our study; 18 men and 14 women. The average age is 65.66 ± 9 years; 75% operated by extra-capsular extraction by phacoemulsification and 25% by manual extra-capsular extraction; All of our patients are pseudophakic. The average time between cataract surgery and Nd-yag LPC is 3 years. The mean IOP is: 13.66 ± 1.7 mmHg before posterior capsulotomy; then after the capsulotomy at 1 hour: 16.59 ± 2.5 mmHg; at 1 day: 15.63 ± 2.1 mmHg; at 7 days: 14.28 ± 1.7 mmHg; at 30 days: 13.84 ± 1.5 mmHg; and at 30 days: 13.75 ± 1.56 mmHg. The most used laser intensity is 2 mj (31.3% of cases) with extremes of 1.8 to 3.2 mj. The most laser pulses interval used is 20 - 30 pulses (40.6%) with extremes of 20 - 52 pulses. The differences observed between the IOP before the Nd-yag laser capsulotomy and the IOP at 1 hour; on 1 day and 7 days after Nd-yag capsulotomy are statistically significant; whereas those observed between the IOP before the capsulotomy and the IOP on 30 days; and at 90 days are not statistically significant. We did not find a correlation between the increase in IOP and the intensity of the laser; also no correlation found between the number of pulses and the increase in IOP.Conclusion: Nd-Yag LPC is a common procedure for treating secondary PCO after cataract surgery; and its most frequent complication remains the increase in IOP. In our series, the increase in IOP was significant within 7 days of capsulotomy and usually normalizes thereafter without any treatment. This increase in IOP was independent of the intensity of the pulse and the number of pulses.

Keywords: Intraocular Pressure (IOP); Posterior Capsule Opacification (PCO); Neodymium-Yttrium-Aluminum-Garnet Laser (Nd-yag Laser), Nd-Yag Laser Posterior Capsulotomy (Nd-yag LPC); Extra-Capsular Cataract Extraction (ECCE)

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Citation

Citation: Saley Hamidou Idrissa., et al. “Intraocular Pressure (IOP) Changes after Posterior Nd-Yag Laser Capsulotomy".Acta Scientific Ophthalmology 4.11 (2021): 02-06.

Copyright

Copyright: © 2021 Saley Hamidou Idrissa., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.