Influence of a modified Nd:YAG laser treatment outside the visual axis on the morphology of Elschnig pearls.

PURPOSE

To observe changes in posterior capsule opacification (PCO) after Nd:YAG treatment with and without opening the posterior lens capsule.

METHOD

This prospective randomized study included patients with regeneratory PCO. In substudy 1, a small low-energy Nd:YAG capsulotomy was performed (MiniYAG). In substudy 2, a low-energy Nd:YAG laser treatment without opening the lens capsule was performed (GentleYAG). Concerning analysis, in both substudies, the posterior capsule was divided into 4 quadrants and the quadrant where the Nd:YAG laser treatment was performed was randomly allocated. Change in PCO was analyzed using retroillumination images objectively (AQUA score: 0-10).

RESULTS

In total, 27 eyes of 25 patients were used for this study. In substudy 1, the mean amount of PCO (AQUA score) for the entire posterior capsule decreased significantly (p < 0.05, ANOVA) from 5.2 (SD: 1.6) before to 4.0 (SD: 1.9) immediately after the MiniYAG. In substudy 2, the mean amount of PCO (AQUA score) for the entire posterior capsule analyzed before and immediately after the GentleYAG was 5.1 (SD: 2.4) and 5.2 (SD: 2.3), respectively.

CONCLUSION

Performing a MiniYAG led to a significant PCO reduction. Gentle polishing of the posterior capsule resulted in a relevant reduction of PCO in one third of the patients.