Parajuli Anil, Joshi Purushottam, Subedi Prabha, Pradhan Chandni
Glaucoma Department.
Retina Department.
Clin Ophthalmol. 2019 Jun 6;13:945-952. doi: 10.2147/OPTH.S203677. eCollection 2019.
To see the effect of Nd:YAG laser capsulotomy on intraocular pressure (IOP), refraction, best-corrected visual acuity (BCVA), anterior chamber depth (ACD), and macular thickness. The authors conducted a prospective, descriptive study on pseudophakic eyes with posterior capsule opacification who underwent Nd:YAG laser capsulotomy. BCVA, IOP, spherical equivalent (SE), macular thickness, and ACD were noted preoperatively, at 1 hr postoperatively and at 1-month follow-up. Patients were divided into two groups based on energy used (Group I ≤50 mJ, Group II >50 mJ). None of the patients received prophylactic antiglaucoma medications either before or after the procedure. There were 96 eyes of 83 patients. Mean total energy levels were 26.64±12.92 mJ in Group I and 81.96±32.10 mJ in Group II. BCVA at 1 hr and 1 month postoperatively improved significantly in both the groups compared to preoperative BCVA (<0.001). There was no significant change in SE compared to preoperative values in both the groups. The ACD continued to increase significantly in both the groups at both 1 hr and 1-month follow-up. In Group I, IOP increased at 1 hr postoperatively (=0.023) and declined to preoperative levels at 1 month. In Group II, IOP increased at 1 hr postoperatively (<0.001) and did not return to preoperative levels at 1-month follow-up (=0.003). Likewise, macular thickness increased at 1 hr in both groups (<0.001). In Group I, macular thickness decreased significantly to preoperative level at 1 month whereas in Group II, it remained significantly high at 1-month follow-up (=0.006). There was no case with serious rise in IOP or cystoid macular edema. Statistically significant increment in IOP and macular thickness occurs after Nd:YAG laser capsulotomy which however may not necessitate the use of any medications.
观察钕钇铝石榴石（Nd:YAG）激光晶状体后囊切开术对眼压（IOP）、屈光、最佳矫正视力（BCVA）、前房深度（ACD）和黄斑厚度的影响。作者对接受Nd:YAG激光晶状体后囊切开术的人工晶状体眼并发后囊膜混浊患者进行了一项前瞻性描述性研究。术前、术后1小时和1个月随访时记录BCVA、IOP、等效球镜度（SE）、黄斑厚度和ACD。根据所用能量将患者分为两组（I组≤50 mJ，II组>50 mJ）。所有患者在手术前后均未接受预防性抗青光眼药物治疗。研究共纳入83例患者的96只眼。I组平均总能量水平为26.64±12.92 mJ，II组为81.96±32.10 mJ。与术前BCVA相比，两组术后1小时和1个月时的BCVA均显著改善（<0.001）。与术前值相比，两组的SE均无显著变化。两组在术后1小时和1个月随访时ACD均持续显著增加。I组术后1小时IOP升高（=0.023），1个月时降至术前水平。II组术后1小时IOP升高（<0.001），1个月随访时未恢复到术前水平（=0.003）。同样，两组术后1小时黄斑厚度均增加（<0.001）。I组1个月时黄斑厚度显著降至术前水平，而II组在1个月随访时仍显著高于术前水平（=0.006）。未出现IOP严重升高或黄斑囊样水肿的病例。Nd:YAG激光晶状体后囊切开术后IOP和黄斑厚度出现统计学上的显著增加，但这可能无需使用任何药物。
