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. 2023 Jun 18;16(6):891-896.
doi: 10.18240/ijo.2023.06.09. eCollection 2023.

Stability of neodymium:YAG laser posterior capsulotomy in eyes with capsular tension rings

Yang Kyung Cho  1 , Min Sun Kim  1
Affiliations

Stability of neodymium:YAG laser posterior capsulotomy in eyes with capsular tension rings

Yang Kyung Cho et al. Int J Ophthalmol. .

Abstract

Aim: To evaluate the stability of neodymium (Nd):YAG laser posterior capsulotomy in eyes with capsular tension rings (CTRs).

Methods: A total of 60 eyes that underwent cataract surgery and laser posterior capsulotomy postoperatively were included in this retrospective cohort study. To evaluate the safety and stability of capsulotomy, changes in the size of posterior capsulotomy and anterior chamber depth (ACD) in three groups: the group without CTR, the group with 12 mm CTRs, and the group with 13 mm CTRs, at 1wk, 3, 12, and 15mo after capsulotomy, were compared.

Results: In the group without CTR and the group with 12 mm CTR, there was no significant change in ACD at every post-laser follow-up. In the group with 13 mm CTR, the ACD change was significant until 3mo after capsulotomy. In all groups, there was a significant increase in the area of capsulotomy between 1wk and 3mo post-laser. Between 3 and 12mo post-laser, only the group with 13 mm CTR showed a significant increase in the area of capsulotomy (P<0.01).

Conclusion: Laser posterior capsulotomy is safe in all three groups. The capsulotomy and ACD become stabilized and have not shown significant changes since 1y post-laser, even with larger CTRs. The maintenance of centrifugal capsular tension can last longer with larger CTRs, and the stability of the capsulotomy site can be reached about 12mo after capsulotomy in pseudophakic eyes with larger CTRs.

Keywords: Nd:YAG laser; capsular tension ring; capsulotomy.

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Figures

Figure 1
Figure 1. Representative picture of the calculation of the neodymium:YAG posterior capsulotomy area percentage
The yellow line (A) represents the total corneal area, and the white line (B) represents the area of the capsulotomy. The capsulotomy area was measured as the percentage area in reference to the total corneal area.
Figure 2
Figure 2. ACD change after Nd:YAG laser capsulotomy according to time in the three groups
ACD change was significant only in group 3, 1wk post-laser compared with before Nd:YAG laser capsulotomy, and the significant ACD change lasted until 3mo post-laser. Group 1: Patients that underwent cataract surgery without CTR insertion and with postoperative Nd:YAG laser capsulotomies; Group 2: Patients that underwent cataract surgery with 12 mm CTRs and Nd:YAG laser capsulotomies; Group 3: Patients that underwent cataract surgery with 13 mm CTRs and Nd:YAG laser capsulotomies. Nd: Neodymium; CTR: Capsular tension ring; ACD: Anterior chamber depth. aP<0.05.
Figure 3
Figure 3. Change in the capsulotomy area (percentage) according to time in the three groups
All three groups showed a significant increase in capsulotomy area between 1wk and 3mo post-laser. Group 3 showed a significant increase in capsulotomy area until 12mo post-laser. Group 1: Patients that underwent cataract surgery without CTR insertion and with postoperative Nd:YAG laser capsulotomies; Group 2: Patients that underwent cataract surgery with 12 mm CTRs and Nd:YAG laser capsulotomies; Group 3: Patients that underwent cataract surgery with 13 mm CTRs and Nd:YAG laser capsulotomies. Nd: Neodymium; CTR: Capsular tension ring. aP<0.05.
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