Comparison of Nd: YAG (Neodymium-Doped Yttrium Aluminum Garnet) Laser Posterior Capsulotomy Techniques in The Treatment of Posterior Capsular Opacification

Article Information

Title: Comparison of Nd: YAG (Neodymium-Doped Yttrium Aluminum Garnet) Laser Posterior Capsulotomy Techniques in The Treatment of Posterior Capsular Opacification

Authors: Shagufta Parveen, Saquib Naeem, Kashif Hanif, Bushra Akbar

Journal: Pakistan Armed Forces Medical Journal (PAFMJ)

HEC Recognition History

Category	From	To
Y	2024-10-01	2025-12-31
Y	2023-07-01	2024-09-30
Y	2021-07-01	2022-06-30
Y	2020-07-01	2021-06-30
Y	1900-01-01	2005-06-30

Publisher: Army Medical College, Rawalpindi.

Country: Pakistan

Year: 2022

Volume: 72

Issue: 1

Language: English

DOI: 10.51253/pafmj.v72i1.3697

Keywords: Hinged capsulotomyPosterior capsular opacificationVitreous strand cuttingYAG laser capsulotomy

Abstract

Objective: To compare the safety and efficacy of different techniques of neodymium: yttrium-aluminum-garnet (Nd: YAG) laser posterior capsulotomy.
Study Design: Quasi-experimental study.
Place and Duration of Study: Combined Military Hospital Nowshera, from Aug 2015 to Mar 2017.
Methodology: A total of 120 patients fulfilling the inclusion criteria were allocated to three groups. Group-A (Circular-group, CG) patients were subjected to circular pattern capsulotomy, group-B (Hinged-group, HG) patients underwent hinged pattern capsulotomy and group-C (Modified-group, MG) had a circular pattern of Nd: YAG posterior capsulotomy along with vitreous strand cutting (modified round pattern). Primary outcome measures were the best-corrected visual acuity (BCVA), intraocular pressure (IOP) and annoying floaters at three-months follow up visits.
Results: The mean age of patients was 52.27 ± 5.65 years and there were 64 (53.3%) males and 56 (46.7%) females. The bestcorrected visual acuity improved significantly (p&lt;0.001) in the modified round pattern group compared to the other two groups at two weeks post-capsulotomy. Intraocular pressure remained unchanged among the three groups. Significantly fewer patients in the modified treatment-group experienced annoying floaters as compared to hinged and circular treatment groups [3 (7.5%) vs 9 (22.5%) vs 12 (30.0%) respectively, p=0.038].
Conclusion: Modified round pattern Nd: YAG laser posterior capsulotomy is a safe and effective method for treating posterior capsular opacification.

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Research Objective

To compare the safety and efficacy of different techniques of neodymium: yttrium-aluminum-garnet (Nd: YAG) laser posterior capsulotomy in treating posterior capsular opacification.

Methodology

Quasi-experimental study involving 120 patients allocated into three groups: Group-A (Circular-group, CG), Group-B (Hinged-group, HG), and Group-C (Modified-group, MG) which involved circular pattern capsulotomy with vitreous strand cutting. Primary outcome measures were best-corrected visual acuity (BCVA), intraocular pressure (IOP), and annoying floaters at three-month follow-up. Data was analyzed using SPSS version 23 with one-way ANOVA, repeated measures ANOVA, and chi-square tests.

Methodology Flowchart

                        graph TD;
    A["Patient Recruitment 120 patients"] --> B["Allocation to 3 Groups"CG, HG, MG""];
    B --> C["Nd: YAG Laser Posterior Capsulotomy"];
    C --> D["Follow-up Visits 2 weeks, 3 months"];
    D --> E["Measure BCVA, IOP, Floaters"];
    E --> F["Data Analysis ANOVA, Chi-square"];
    F --> G["Conclusion"];

Discussion

Nd: YAG laser posterior capsulotomy is effective for treating PCO. The modified round pattern technique, which includes vitreous strand cutting, appears to offer better visual acuity recovery and reduced floaters compared to conventional circular and hinged patterns. While concerns about increased energy consumption exist, the study found no complications like retinal detachment. The use of Timolol eye drops helped maintain stable intraocular pressure.

Key Findings

The modified round pattern group showed a significant improvement in best-corrected visual acuity at two weeks post-capsulotomy compared to the other two groups (p<0.001). Intraocular pressure remained unchanged across all groups. Significantly fewer patients in the modified treatment group experienced annoying floaters (7.5%) compared to the hinged (22.5%) and circular (30.0%) groups (p=0.038).

Conclusion

The modified round pattern Nd: YAG laser posterior capsulotomy is a safe and effective method for treating posterior capsular opacification, offering rapid visual rehabilitation and reduced floaters.

Fact Check

- The study included 120 patients. (Confirmed in Methodology)
- The mean age of patients was 52.27 ± 5.65 years. (Confirmed in Results)
- Significantly fewer patients in the modified treatment group experienced annoying floaters: 7.5% vs 22.5% vs 30.0%. (Confirmed in Results)

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