YAG capsulotomy safe, effective when performed by optometrists
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Key takeaways:
- In a post-procedure survey, 99% of participants noted an improvement in vision.
- Snellen visual acuity improved from an average of 20/40 to 20/23, with no serious complications reported.
Patients who underwent YAG laser capsulotomy performed by an optometrist had improved visual acuity with no serious complications, according to research published in Optometry and Vision Science.
“This study demonstrates that capsulotomies can be effectively and safely performed by doctors of optometry with minimal risk to patients and significant benefit to visual function and provides evidence to support the use of YAG capsulotomy in optometric practice,” Nathan Lighthizer, OD, FAAO, from Northeastern State University Oklahoma College of Optometry, and colleagues wrote.
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Researchers conducted a prospective study of 92 eyes from 79 patients diagnosed with posterior capsule opacification at six primary care optometry clinics. All participants had reduced Snellen visual acuity (worse than 20/40) and subjective visual complaints.
Optometrists recorded patients’ corrected distance visual acuity, IOP, macular thickness and central lens defects before performing Nd:YAG 1064 nm laser capsulotomy, and rechecked IOP 1 hour after the procedure. Subsequent follow-up visits were scheduled at 1 week, 1 month and 3 months, at which time participants were asked whether they experienced subjective improvement in vision.
At baseline, the mean visual acuity was 0.302 logMAR +/– 0.208 (20/40 Snellen acuity), which improved to 0.058 +/–0.07 logMAR (20/23) at the 1-month follow-up. When including those who completed the 3-month follow-up (n = 69), the mean pre-procedure visual acuity was 0.305 logMAR +/– 0.214 (20/41), which improved to 0.054 logMAR +/– 0.069 (20/23; P < .001 for all).
Researchers also reported an average central macular thickness of 252.9 microns at baseline, which decreased to 252.7 microns after the procedure, an insignificant difference.
When asked in a post-procedure survey whether their vision had improved, 99% of participants reported a subjective improvement in vision.
Only four participants experienced an increase in IOP above 5 mm Hg after the procedure, and none experienced significant inflammation, vitreous floaters, corneal edema, cystoid macular edema, retinal detachment or permanent vision loss.
“Based on the outcomes of this study, YAG laser capsulotomies are effective treatments to improve patient vision that can be safely and effectively performed by optometrists,” Lighthizer and colleagues wrote.
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