Waseem Muhammad, Khan Haseeb Ahmed
Department of Ophthalmology, PNS Shifa Hospital, Karachi.
J Coll Physicians Surg Pak. 2010 Aug;20(8):524-7.
To determine the frequency of raised intraocular pressure (IOP) after Nd: YAG laser posterior capsulotomy and its association with the energy used with raised versus normal intraocular pressure in pseudophakes.
Comparative, cross-sectional study.
Ophthalmology Department, PNS Shifa Hospital, Karachi, from August 2008 to February 2009.
Pseudophakes having poor vision due to posterior capsular opacification (PCO) in an otherwise normal looking eye and intraocular pressure between 10-20 mmHg were included in the study. Patients with diabetic retinopathy, corneal diseases, inflammatory eye diseases, posterior segment surgery, glaucoma, trabeculectomy, maculopathy and any systemic disease were excluded from the study. Particulars of the eligible patients and pre-laser intraocular pressure were entered in specially designed proforma. Nd: YAG laser posterior capsulotomy was done. Laser energy used was noted and then their post-laser intraocular pressure was checked after 4 hours. Unpaired t-test was used for comparison of means of IOP and energy levels. Chi-square test was applied to compare the proportions of patients with raised and the normal IOP with YAG laser energy used during posterior capsulotomy.
Raised intraocular pressure (IOP>or=5 mmHg from the baseline) after Nd: YAG laser posterior capsulotomy was noted in both the 'low energy' and the 'high energy' groups but it was more common in the 'high energy' group (p<0.001, r=0.512).
Higher YAG laser energy has significantly higher chances of raising IOP. Hence, it was recommended that each patient undergoing Nd: YAG laser capsulotomy should receive minimum possible laser energy and must be followed up for raised intraocular pressure.
确定钕:钇铝石榴石激光后囊切开术后眼压升高的频率及其与人工晶状体眼中眼压升高和正常眼压时所用能量的关系。
比较性横断面研究。
2008年8月至2009年2月,卡拉奇PNS希法医院眼科。
纳入因后囊混浊(PCO)导致视力不佳、外观正常且眼压在10 - 20 mmHg之间的人工晶状体眼患者。糖尿病视网膜病变、角膜疾病、炎症性眼病、后段手术、青光眼、小梁切除术、黄斑病变及任何全身性疾病患者被排除在研究之外。符合条件的患者详情及激光术前眼压被录入专门设计的表格。进行钕:钇铝石榴石激光后囊切开术。记录所用激光能量,然后在4小时后检查其激光术后眼压。采用不成对t检验比较眼压均值和能量水平。应用卡方检验比较后囊切开术期间使用不同钇铝石榴石激光能量时眼压升高和正常的患者比例。
“低能量”组和“高能量”组在钕:钇铝石榴石激光后囊切开术后均出现眼压升高(眼压较基线升高≥5 mmHg),但在“高能量”组更常见(p<0.001,r = 0.512)。
较高的钇铝石榴石激光能量显著增加眼压升高的几率。因此,建议每位接受钕:钇铝石榴石激光囊切开术的患者应接受尽可能低剂量的激光能量,并必须对眼压升高情况进行随访。