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ND: YAG LASER CAPSULOTOMY AND COMPLICATIONS
EJAZ AHMAD JAVED
The Professional Medical Journal , 2007,
Abstract: Objectives: To evaluate the complications of Nd:Yag laser when applied onpostoperative posterior capsule opacification (PCO), following extra capsular cataract extraction (ECCE) with intraocularlens (IOL). Design: Analytical and descriptive study. Setting: Eye OPD of DHQ Hospital, PMC and Clinic of ProfessorZia ud Din Ahmad, Faisalabad. Period: From Jan 2006 to Jan 2007. Material & Methods. There were 120 patients;age ranged from 15 years to 80 years with post operated extra capsular cataract extraction with posterior capsularopacification. A Proforma was made which included detailed history of diabetes, hypertension, time period of cataractextraction, other relevant surgical or medical history, and examination e.g. Visual acuity, slit lamp examination,intraocular pressure measurement (applanation tonometry) dilated posterior capsule examination and slit lampbiomicroscopy etc. The patients were kept under observation for 5 hour and called for follow up after one week.Results. Out of 120 patients 70 eyes showed visual improvement from 6/18 to 6/6 (58.34%), while 30 Shown visualacuity improvement from count figures to 6/24 (25%), mild anterior uveitis occurred in 8 cases (6.67%), corneal damagein 2 cases (1.6%) while transient raised Intraocular Pressure (IOP) in 7 cases (5.83%). The damage to IOL observedin 3(2.5%), the corneal damage was seen in 2 cases (1.67%). Conclusions: The Nd; Yag Laser is very effective, cheapand easy mode of treatment for PCO with minimal post laser complications.
Complicaciones de la capsulotomía posterior por láser de Nd-Yag en el Centro Oftalmológico "Enrique Cabrera" de La Habana Complications of posterior capsulotomy due to Nd-Yag laser in "Enrique Cabrera" Ophthalmological Center from Havana
Carlos A Botella Valle,Vladimir O Torriente Torriente,Zoila C Martínez Legón,Idalia Triana Casado
MEDISAN , 2012,
Abstract: Introducción: La opacidad capsular posterior es la complicación más frecuente de la cirugía de catarata y, aunque la capsulotomía con láser de Nd-Yag es un procedimiento muy efectivo para solucionarla, no está exenta de complicaciones.Objetivo: Describir las complicaciones en pacientes expuestos a capsulotomía con láser de Nd-Yag.Métodos: Se realizó un estudio descriptivo y prospectivo de 104 pacientes con opacidad capsular posterior, atendidos en el Centro Oftalmológico "Enrique Cabrera" de la Habana, durante el 2010. Se analizaron las variables frecuencia y tipo de complicaciones, edad, sexo, antecedentes patológicos personales oculares y sistémicos, clasificación de la opacidad capsular, energía utilizada, así como agudeza visual antes y después del tratamiento.Resultados: En la casuística predominaron el aumento de la presión intraocular y el edema macular quístico como las complicaciones más comunes, los pacientes de 56-75 a os, el sexo femenino, así como la opacidad capsular fibrótica y la capsulotomía con más de 8,0 MJ.Conclusiones: Más de la mitad de los afectados presentaron complicaciones de carácter transitorio y reversible, las cuales no estuvieron relacionadas con la cantidad de energía empleada; la mejoría visual después del proceder fue notable. Introduction: The posterior capsular opacity is the most frequent complication in the cataract surgery and, although capsulotomy with Nd-Yag laser is a very effective procedure to solve it, it is not free of complications. Objective: To describe the complications in patients exposed to capsulotomy with Nd-Yag laser.Methods: A descriptive and prospective study of 104 patients with posterior capsular opacity, assisted in "Enrique Cabrera" Ophthalmological Center from Havana, was carried out during the 2010. Variables of frequency and type of complication, age, sex, pathological ocular and systemic medical history, classification of the capsular opacity, energy used, as well as visual acuity before and after the treatment were analyzed.Results: The increase of the intraocular pressure and the cystic macular edema as the most common complications, the 56-75 year-old patients, female sex, as well as the capsular fibrotic opacity and the capsulotomy with more than 8,0 MJ prevailed in the case material.Conclusions: More than half of the patients presented complications of transitory and reversible type, which were not related to the quantity of energy used; the visual improvement after the procedure was remarkable.
Preoperative Nd:YAG laser anterior capsulotomy in white intumescent cataracts: report of 11 cases
Coelho, Roberto Pinto;Paula, Jayter Silva;Silva, Rafael Nery e;Garcia, Tatiana Vannucci;Martin, Luiz Fernando Taranta;
Arquivos Brasileiros de Oftalmologia , 2009, DOI: 10.1590/S0004-27492009000100024
Abstract: creating a continuous curvilinear capsulorhexis in eyes with white intumescent cataracts is a challenge due to the high risk of extension of capsular tears to the lens periphery. several approaches have been described to avoid this complication and preoperative nd:yag laser anterior capsulotomy has been little reported as an optional technique. eleven patients with white intumescent cataracts were submitted to preoperative nd:yag laser anterior capsulotomy. all patients had some degree of cortex falling in anterior chamber after laser application. no patient developed later complications. thus, preoperative nd:yag laser anterior capsulotomy represents a safe and easy option for white intumescent cataracts.
Nd:YAG Laser Posterior Capsulotomy and Visual Outcome  [cached]
Khaleda Nazneen Bari
Delta Medical College Journal , 2013, DOI: http://dx.doi.org/10.3329/dmcj.v1i1.14971
Abstract: Background: Neodymium-doped yttrium aluminum garnet (Nd:YAG) laser capsulotomy is a relatively noninvasive procedure that is used in the treatment of posterior capsular opacification (PCO). PCO is caused by proliferation of lens epithelial cells which causes fibrotic changes and wrinkling of the posterior capsule and results in decreased vision, glare, and other symptoms similar to that of the original cataract.Objective: To find out the visual outcome after performing Nd:YAG laser capsulotomy for PCO.Materials and method: A prospective clinical trial was carried out in National Institute of Ophthalmology (NIO), Dhaka, Bangladesh from January 2010 to June 2011 on purposively selected 70 adult subjects of both sexes who developed PCO within 2 months to more than 2 years after extracapsular cataract extraction with posterior chamber intra ocular lens implant. After thorough pre laser assessment Nd:YAG laser capsulotomy was carried out with Zeis VISULAS YAG II through Zeiss slit lamp under topical anesthesia. Data were recorded and expressed as proportion.Results: Out of the 70 subjects 40 were male and 30 were female. The average time interval of cataract surgery and Nd: YAG laser capsulotomy was 23 months. Capsular fibrosis (57.04%) was the predominant type of PCO. The pre laser visual acuity (VA) of more than 61.06% of eyes was 6/36 or below while 41.12% had VA hand movements to finger count. After Nd:YAG laser capsulotomy VA of 6/18 or better was achieved in 63.9% of eyes while 9.94% recovered to 6/9 and 11.36% achieved 6/6. None of these eyes showed further deterioration in VA.Conclusion: Nd:YAG laser capsulotomy for PCO is safe, effective and a rewarding procedure for improvement of vision.
Methods of assessment of patients for Nd:YAG laser capsulotomy that correlate with final visual improvement
Tariq M Aslam, Niall Patton
BMC Ophthalmology , 2004, DOI: 10.1186/1471-2415-4-13
Abstract: 24 patients attending for capsulotomy had pre-operative measures of glare with BAT tester, visibility of posterior pole and grading of posterior capsular pearls and fibrosis seen at slit lamp. Visual function was measured before and after standardised capsulotomy. Correlations of the various preoperative measures with eventual visual function improvements were calculated.Pearls at slit lamp and poor posterior pole visualisation were all correlated with improvements in visual acuity and contrast sensitivity after capsulotomy. Amount of fibrosis visible at slit lamp and glare assessment were not correlated with vision improvements after laser.Of the various measures that are taken prior to Nd : YAG capsulotomy, some correlate with eventual visual improvement but for others no clinical utility was found. Practitioners should note these findings as they are especially of use in more questionable or high-risk cases to help determine whether referral for PCO treatment by Nd: YAG capsulotomy is likely to benefit the patient.Posterior capsular opacification (PCO) remains one of the most common post operative morbidities in modern day cataract surgery [1,2] and Nd:YAG posterior capsulotomy is one of the most commonly performed surgical procedures.However, the Nd: YAG capsulotomy procedure has been associated with complications such as damage to intraocular lenses [3], post operative intraocular pressure increases [4], cystoid macular oedema [4], disruption of the anterior vitreous face [5] and increased incidence of retinal detachment [6].Until recently Nd:YAG laser treatments have cost the U.S healthcare system up to $250 million annually [7]. Apart from exposing a patient to unnecessary risk, unqualified capsulotomies worsen this burden to the developed and developing world [8].PCO is an extremely common development in patients after cataract extraction and in many mild cases it may not be immediately obvious whether it is visually significant. Patients may have reduced vi
"String of Pearls" following Nd:YAG laser posterior capsulotomy  [cached]
Chatterjee Samrat,Garg Prashant
Indian Journal of Ophthalmology , 2002,
Abstract: Posterior capsular re-opacification can occur following Nd-YAG capsulotomy. This necessitates multiple capsulotomies with its potential complications. We report one such case and discuss possible predisposing factors and preventive measures for this condition
Efectividad del Nd- Yag láser en la capsulotomía posterior Effectiveness of Nd-Yag laser in posterior capsulotomy
Alina Pedroso Llanes,Katia Trujillo Fonseca,Reinaldo Ríos Caso
Revista Cubana de Oftalmolog?-a , 2004,
Abstract: Este trabajo se propuso determinar la efectividad del neodimio YAG láser (Nd-YAG láser) en la realización de capsulotomía posterior a 150 pacientes (ojos) operados de catarata senil o presenil en el centro de Microcirugía Ocular en Serie del Hospital Oftalmológico Docente "Ramón Pando Ferrer" en el período comprendido de febreroa diciembre de 1999. En este grupo se analizaron como variables la edad, sexo, raza, implante o no de lente intraocular, tipo de opacidad de cápsula posterior, agudeza visual con corrección pre y postratamiento, complicaciones encontradas, comportamiento de la presión intraocular, así como la energía empleada para realizar dicho proceder. Estos datos se analizaron a través de tablas de contingencias Chi cuadrado. Como resultado de esta investigación se encontró que el láser es altamente efectivo para el mejoramiento de la agudeza visual en los pacientes afectados de catarata secundaria (74,7 %). Se observó además aumento transitorio de la presión intraocular en las dos primeras horas posteriores al láser (60,7 %), y no se encontró ninguna complicación que afectara la visión de los ojos estudiados The aim of this paper was to determine the effectiveness of neodymium YAG laser (Nd-YAG laser) on performing the posterior capsulotomy in 150 patients (eyes) operated on of senile or presenile cataract at the Center of Serial Ocular Microsurgery (CSOM) of "Ramón Pando Ferrer" Ophthalmological Teaching Hospital from February to December 1999. Age, sex, race, implantation or not of the intraocular lens (IOL), type of opacity of the posterior capsule, visual acuity with pre- and posttreatment correction (Avcc), complications found, behavior of the intraocular pressure (IOP), as well as the energy used to carry out such procedure, were analyzed. The Chi square contingency tables were used to this end. As a result of this research, it was found that the laser is highly effective for improving visual acuity in patients affected with secondary cataract (74.7 %). It was also observed a transitory increase of the IOP during the first 2 hours after laser (60.7 %) It was not observed any complication affecting the vision of the studied eyes
Nd: YAG capsulotomy for posterior capsule opacification after combined clear corneal phacoemulsification and vitrectomy
Ilias Georgalas,Petros Petrou,George Kalantzis,Dimitrios Papaconstantinou
Therapeutics and Clinical Risk Management , 2009,
Abstract: Ilias Georgalas1, Petros Petrou2, George Kalantzis2, Dimitrios Papaconstantinou2, Chrysanthi Koutsandrea2, Ioannis Ladas21Department of Ophthalmology, “G. Gennimatas” Hospital of Athens, NHS, Athens, Greece; 2Department of Ophthalmology, University of Athens, Athens, GreecePurpose: To evaluate the efficacy and safety of Neodymium:YAG (Nd:YAG) laser capsulotomy for posterior capsule opacification (PCO) following combined phacoemulsification and vitrectomy for the treatment of cataract in association with macular hole (MH) or epiretinal membrane (ERM).Methods: Retrospective clinical study of 34 eyes of 34 patients who underwent combined cataract surgery and vitrectomy, developed PCO, and subsequently underwent Nd:YAG laser capsulotomy. Follow-up examinations included visual acuity measurement, evaluation of intraocular lens (IOL) centration, intraocular pressure (IOP) measurement, and dilated fundus examination.Results: Nd:YAG laser capsulotomy was performed in all 34 eyes. The mean age of the patients was 65.08 years (range 45–87) and the mean follow up period was 11.05 months (range 4–23). The mean time elapsed between the last intraocular operation and the development of PCO was 10.00 months for patients with previous ERM and 15.33 for those with MH (P = 0.001, t-test for equality of means). None of our patients developed recurrence of MH, retinal detachment, IOL dislocation, or permanent IOP elevation.Conclusion: In our study, the most remarkable observation is that no complication occurred after the YAG capsulotomy, possibly because the eyes were vitrectomized and vitreous seems to play an important role in the occurrence of post-Nd:YAG complications. In addition we noted that PCO seems to occur earlier in the eyes undergoing combined surgery for cataract and ERM when compared with those where combined phacoemulsification and vitrectomy are performed for cataract and MH.Keywords: Nd:YAG capsulotomy, phacoemulsification, vitrectomy
Estimation of mean ND: Yag laser capsulotomy energy levels for membranous and fibrous posterior capsular opacification  [PDF]
R Bhargava,P Kumar,A Prakash,KP Chaudhary
Nepalese Journal of Ophthalmology , 2012, DOI: 10.3126/nepjoph.v4i1.5861
Abstract: Introduction: Posterior capsule opacification (PCO) is a visually-disabling complication of cataract surgery. Objective: To estimate energy levels for capsulotomy in various subtypes of PCO (membranous, fibrous and fibro-membranous). Materials and methods: A total of 215 patients with PCO were randomly selected and evaluated for Nd: Yag laser capsulotomy, after a quiet post-operative course of 3 months. The ocular area was arbitrarily divided into three zones: YAG zone (3mm), Optical zone (6 mm) and the peripheral zone (12mm). A colour code was assigned to the subtype of PCO in these zones: fibrous green and membranous blue. The type of PCO in each quadrant of YAG zone was estimated in percentage. Results: The statistic mean values of initial energy levels were 1.80 mJ for membranous PCO, 3.17 mJ for fibrous PCO and 2.73 mJ for fibro-membranous PCO. The mean summated energy levels for membranous PCO was 22.80 mJ for membranous PCO, 80.06 mJ for fibrous PCO and 80.48 mJ for fibro-membranous type. Conclusion: Colour coding is extremely helpful for quantification of the type of PCO and in deciding the initial energy level necessary to create capsulotomy. Fibro-membranous PCO required more summated energy despite a lower starting energy. Therefore, we recommend firing the initial shot in fibrous portion in case of fibrous-membranous type of PCO. DOI: http://dx.doi.org/10.3126/nepjoph.v4i1.5861 NEPJOPH 2012; 4(1): 108-113
Resultados de la capsulotomía Nd-YAG láser Results of the capsulotomy Nd-YAG LASER
Mirlanea López Torres,Felipe Acosta Rodrígue,Yaiselys Hernández Díaz
Revista de Ciencias M??dicas de Pinar del R?-o , 2009,
Abstract: La catarata es una de las principales causas de ceguera en todo el mundo y su extracción quirúrgica es la única terapia admitida como eficaz. Dentro de las complicaciones más frecuentes está la opacidad de la cápsula posterior del cristalino, ésta puede aparecer meses o a os después de la cirugía. Ocurre entre el 20% y el 50% de los pacientes en un periodo de 5 a os posteriores a la misma. La capsulotomía posterior puede realizarse mediante maniobras manuales con el instrumental tradicional, o con láser, siendo este último la modalidad habitual en la época actual; por estas razones se realiza esta investigación, para conocer los resultados obtenidos después de la capsulotomía con láser en los pacientes operados de catarata por la Técnica Blumenthal en el Hospital Universitario Abel Santamaría Cuadrado, en Pinar del Río (Cuba), durante el periodo junio 2007-mayo 2008. Para ello se tuvieron en cuenta las variables: edad, sexo, implante o no de lente intraocular, complicaciones trans y post láser, así como agudeza visual pre y post tratamiento. El 80.2% de los pacientes estudiados tenía >60 a os de edad y en un 96,8% se colocó lente intraocular en cámara posterior. El 65.9% de los ojos presentó elevación transitoria de la presión intraocular y sólo en un 3.2% hubo astillamiento del lente intraocular sin necesidad de extracción. Las complicaciones no cobraron importancia si se considera que el 93.2% de los ojos alcanzó una agudeza visual >0.7. Cataracts are one of the main causes of blindness all over the world and its surgical removal is the only effective therapy admitted. The opacity of the posterior capsule of the lens is the most frequent post-surgical complication. This may appear months or years after surgery and is present in 20-50 % of the patients after 5 years of their surgical intervention. The posterior capsulotomy may be performed by means of manual procedures using the traditional instrumentation, or by means of laser; the current technique nowadays. Showing the results after laser capsulotomy in patients operated by the Blumenthal Technique (2007-2008) at "Abel Santamaria Cuadrado" University Hospital, in Pinar del Rio Cuba was the purpose of this paper. Age, sex, implant and non- implant of the intraocular lenses (IOL), complications during trans and post laser therapy, as well as the visual acuity before and after treatment were the variables considered, all patients were older than 60 years (80, 2 %) and in 96, 8 % an intraocular lens was placed into the posterior chamber, 65.9 % of the eyes showed transient increasing of the intraocular
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