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Low energy minimizes IOP spike after Nd:YAG capsulotomy
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The increases in IOP and macular thickness that occur after Nd:YAG laser posterior capsulotomy were less pronounced when the total energy level was low and proper prophylaxis was employed, according to a study.
“Using a total energy level less than 80 mJ seems to be safer and use of prophylactic antiglaucomatous and anti-inflammatory agents before the Nd:YAG laser capsulotomy and 3 days postoperatively is effective to prevent an acute and serious increase in IOP,” the study authors said.
The study included 30 eyes of 30 patients with posterior capsule opacification after phacoemulsification and implantation of an AcrySof posterior chamber hydrophobic IOL (Alcon). Patients were grouped according to total energy level used during Nd:YAG capsulotomy: 80 mJ or less (first group) or 80 mJ or more (second group).
Total energy level used in Nd:YAG capsulotomy was 58 mJ in the first group and 117 mJ in the second group; the between-group difference was statistically significant (P < .001).
Best corrected visual acuity, biomicroscopy, Goldmann applanation tonometry and macular thickness measurement with optical coherence tomography were performed preoperatively and at 1 week, 1 month and 3 months postoperatively.
Study results showed that IOP increased significantly at 1 week postop (P = .007) but reverted to the preoperative level at 1 month in the first group. In the second group, IOP also increased significantly at 1 week (P = .001) but did not revert to the preoperative level at 3 months.
Macular thickness increased in both groups, but the increase was significantly higher in the second group than in the first group at 1 week (P = .004) and 1 month (P = .03).
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Ophthalmic Surg Lasers Imaging. 2012;43(5):395-400.
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