Ayla Serhat, Seyyar Sevim Ayça, Güngör Kıvanç
Ophthalmology Clinic, Şırnak State Hospital, Şırnak, Turkey.
Ophthalmology Department, Gaziantep University Hospital, Gaziantep, Turkey.
Clin Exp Optom. 2025 Aug 4:1-11. doi: 10.1080/08164622.2025.2542325.
Nd:YAG laser capsulotomy is a standard treatment for posterior capsule opacification. While effective, it may induce subclinical changes in retinal structure or perfusion. Optical coherence tomography angiography enables non-invasive visualisation of retinal microvasculature and is a valuable tool for monitoring potential vascular effects of intraocular laser procedures.
Posterior capsule opacification is the most common delayed complication following cataract surgery. Nd:YAG laser posterior capsulotomy is the standard treatment, but its effects on retinal microcirculation remain under-investigated. Optical coherence tomography angiography offers high-resolution vascular imaging but differentiating true vascular alterations from improved visualisation after media clearing presents a diagnostic challenge.
This prospective study included 30 pseudophakic patients undergoing Nd:YAG capsulotomy for visually significant posterior capsule opacification. optical coherence tomography angiography imaging was performed at baseline, 1 hour, 1 week, and 1 month after treatment. The untreated pseudophakic fellow eyes of 25 patients served as internal controls. Vessel density measurements were obtained from the superficial capillary plexus (SCP-VD), deep capillary plexus (DCP-VD), and radial peripapillary capillaries. Intra-group changes were analysed with repeated measures ANOVA, and inter-eye comparisons were performed using independent samples t-tests.
SCP-VD showed significant increases in nasal and inferior parafoveal and perifoveal sectors at 1 week and 1 month ( < 0.05). DCP-VD also increased postoperatively, particularly in the foveal and superior perifoveal areas. Deep foveal vascular density at 1 month was significantly higher than in fellow eyes ( = 0.013). Peripapillary capillaries vascular density increased significantly over time ( = 0.035), though inter-eye differences were not significant.
Optical coherence tomography angiography detects localised vascular changes following Nd:YAG capsulotomy. Incorporating fellow-eye controls strengthens interpretive accuracy by minimising the confounding effects of image quality improvement, supporting the clinical use of optical coherence tomography angiography in postoperative retinal assessment of pseudophakic patients.
钕：钇铝石榴石激光晶状体后囊切开术是后囊膜混浊的标准治疗方法。虽然有效，但它可能会引起视网膜结构或灌注的亚临床变化。光学相干断层扫描血管造影能够无创地可视化视网膜微血管，是监测眼内激光手术潜在血管效应的宝贵工具。
后囊膜混浊是白内障手术后最常见的延迟并发症。钕：钇铝石榴石激光后囊切开术是标准治疗方法，但其对视网膜微循环的影响仍研究不足。光学相干断层扫描血管造影提供高分辨率血管成像，但将真正的血管改变与介质清除后改善的可视化区分开来是一项诊断挑战。
这项前瞻性研究纳入了30例因具有视觉意义的后囊膜混浊而接受钕：钇铝石榴石晶状体后囊切开术的人工晶状体眼患者。在治疗前、治疗后1小时、1周和1个月进行光学相干断层扫描血管造影成像。25例患者未治疗的人工晶状体眼对侧眼作为内部对照。从浅表毛细血管丛（SCP-VD）、深部毛细血管丛（DCP-VD）和视盘周围放射状毛细血管获得血管密度测量值。组内变化采用重复测量方差分析进行分析，眼间比较采用独立样本t检验。
SCP-VD在术后1周和1个月时，鼻侧和下方黄斑旁及黄斑周围区域显著增加（<0.05）。DCP-VD术后也增加，特别是在黄斑和上方黄斑周围区域。术后1个月时，黄斑中心凹深部血管密度显著高于对侧眼（=0.013）。视盘周围毛细血管血管密度随时间显著增加（=0.035），但眼间差异不显著。
光学相干断层扫描血管造影可检测钕：钇铝石榴石晶状体后囊切开术后的局部血管变化。纳入对侧眼对照通过最小化图像质量改善的混杂效应来提高解释准确性，支持光学相干断层扫描血管造影在人工晶状体眼患者术后视网膜评估中的临床应用。
