Department of Ophthalmology, Government Medical College, Nagpur, Maharashtra, India.
Indian J Ophthalmol. 2023 Mar;71(3):791-796. doi: 10.4103/ijo.IJO_1885_22.
To study the complication rate following Nd: YAG posterior capsulotomy posterior capsular opacification (PCO) in patients with and without comorbid conditions.
This was a prospective, interventional, comparative, and observational study. A total of 80 eyes, consisting of 40 eyes without ocular comorbidities (group A) and 40 eyes with ocular comorbidities (group B) that were being treated with Nd: YAG capsulotomy for PCO, were included. Visual outcome and complications of Nd: YAG capsulotomy were studied.
The mean age of group A patients was 61.65 ± 8.85 years and that of group B patients was 63 ± 10.46 years. Of the total, 38 (47.5%) were men and 42 (52.5%) were women. In group B, the ocular comorbidities were moderate nonproliferative diabetic retinopathy (NPDR) (n = 14 eyes; 14/40 = 35%), subluxated intraocular lens (IOL; <2 clock hours of subluxation; n = 6), age-related macular degeneration (ARMD; n = 6), post-uveitic eyes (having old signs of uveitis, no episode of uveitis since the last 1 year; n = 5), and operated cases of traumatic cataract (n = 4). The mean energy required in groups A and B was 46.95 ± 25.92 and 42.62 ± 21.85 mJ, respectively (P = 0.422). The average energy requirement in Grade 2, Grade 3, and Grade 4 PCO was 22.30, 41.62, and 79.52 mJ, respectively. An increase in intraocular pressure (IOP) of >5 mmHg from pre-YAG levels was observed in one patient in each group on day 1 postprocedure, for which medical treatment was given to both patients for 7 days. One patient in each group had IOL pitting. No patient had any other complications attributable to ND:YAG capsulotomy.
Nd:YAG laser posterior capsulotomy is a safe procedure for PCO in patients with comorbidities. Visual outcomes were excellent after Nd:YAG posterior capsulotomy. Although a transient increase in IOP was noted, the response to treatment was good and a long-term increase in IOP was not observed.
研究 Nd:YAG 后囊切开术治疗合并和不合并合并症的后发性白内障（PCO）患者的并发症发生率。
这是一项前瞻性、干预性、对照和观察性研究。共纳入 80 只眼，其中 40 只眼无眼部合并症（A 组），40 只眼有眼部合并症（B 组），均行 Nd:YAG 后囊切开术治疗 PCO。研究 Nd:YAG 后囊切开术的视力结果和并发症。
A 组患者的平均年龄为 61.65±8.85 岁，B 组患者的平均年龄为 63±10.46 岁。其中，男性 38 只（47.5%），女性 42 只（52.5%）。B 组的眼部合并症为中度非增殖性糖尿病视网膜病变（NPDR）（14 只眼，14/40=35%）、晶状体半脱位（<2 时钟小时的半脱位，6 只眼）、年龄相关性黄斑变性（AMD，6 只眼）、葡萄膜炎后眼（有陈旧性葡萄膜炎体征，过去 1 年无葡萄膜炎发作，5 只眼）和外伤性白内障手术眼（4 只眼）。A 组和 B 组所需的平均能量分别为 46.95±25.92mJ 和 42.62±21.85mJ（P=0.422）。2 级、3 级和 4 级 PCO 所需的平均能量分别为 22.30、41.62 和 79.52mJ。术后第 1 天，每组各有 1 例患者的眼压（IOP）比 YAG 前升高>5mmHg，对这 2 例患者均给予了 7 天的药物治疗。每组各有 1 例患者的 IOL 出现压痕。没有患者出现归因于 ND:YAG 后囊切开术的其他并发症。
Nd:YAG 激光后囊切开术是治疗合并症患者 PCO 的一种安全方法。Nd:YAG 后囊切开术后视力结果良好。虽然观察到眼压一过性升高，但对治疗的反应良好，未观察到眼压长期升高。
