Mutaf Çağrı, Reyhan Ali Hakim, Bulut Mübeccel, Yüksekyayla Funda
Department of Ophthalmology, Faculty of Medicine, Harran University, 63100 Şanlıurfa, Türkiye.
Department of Ophthalmology, Necip Fazil City Hospital, 63300 Kahramanmaras, Türkiye.
Diagnostics (Basel). 2025 Sep 8;15(17):2280. doi: 10.3390/diagnostics15172280.
This prospective observational study was conducted to systematically assess immediate changes occurring (within one hour) in corneal endothelial cell morphology and anterior segment parameters following Nd:YAG laser posterior capsulotomy in pseudophakic patients and to analyze the correlation between these changes and laser energy parameters. A single-arm, within-subject pre-post design was employed to evaluate corneal endothelial morphology (cell density, count, area, coefficient of variation and hexagonal percentage) and anterior chamber parameters (depth, angle, volume) before and one hour after the procedure using specular microscopy and Pentacam analysis. Patient demographics (age), clinical parameters (best corrected visual acuity and intraocular pressure), postoperative-YAG laser interval, and laser energy parameters (energy per shot, pulse count, and total applied energy) were also documented. Thirty-two pseudophakic patients (mean age 56.3 ± 19.2 years) underwent Nd:YAG laser posterior capsulotomy with mean energy per shot of 3.15 ± 1.07 mJ and pulse count of 34.3 ± 20.4. Specular microscopy revealed significant post-procedural decreases in endothelial cell density (2184.05 to 2057.2 cells/mm; = 0.006) and increases in average cell area (529.25 ± 242.72 to 587.75 ± 281.09 µm; = 0.004) and minimum cell area (199.3 ± 170.62 to 248.35 ± 202.7 µm; = 0.035). Corneal topography also decreased significantly in the anterior chamber angle (40.07 ± 10.34 to 35.42 ± 6.78 degrees; = 0.048), with positive correlations between energy per shot and endothelial cell density (r = 0.557; = 0.011) and average cell area (r = 0.544; = 0.013). This study demonstrates that Nd:YAG laser capsulotomy causes immediate, energy-dependent alterations in corneal endothelial density and anterior chamber parameters within one hour post-procedurally. The identification of energy per shot as a key determinant represents a preliminary observation for optimizing laser parameters and reducing potential complications in pseudophakic patients.
钇铝石榴石激光后囊切开术后一小时内角膜内皮细胞形态和眼前节参数的即时变化，并分析这些变化与激光能量参数之间的相关性。采用单臂、受试者自身前后对照设计，使用镜面显微镜和Pentacam分析评估手术前和术后一小时的角膜内皮形态（细胞密度、计数、面积、变异系数和六边形百分比）和前房参数（深度、角度、容积）。还记录了患者的人口统计学数据（年龄）、临床参数（最佳矫正视力和眼压）、术后与YAG激光间隔时间以及激光能量参数（每次脉冲能量、脉冲计数和总应用能量）。32例人工晶状体植入术后患者（平均年龄56.3±19.2岁）接受了钕:钇铝石榴石激光后囊切开术，平均每次脉冲能量为3.15±1.07 mJ，脉冲计数为34.3±20.4。镜面显微镜检查显示，术后内皮细胞密度显著降低（从2184.05降至2057.2个细胞/mm²；P = 0.006），平均细胞面积增加（从529.25±242.72 µm²增至587.75±281.09 µm²；P = 0.004），最小细胞面积增加（从199.3±170.62 µm²增至248.35±202.7 µm²；P = 0.035）。前房角的角膜地形图也显著降低（从40.07±10.34度降至35.42±6.78度；P = 0.048），每次脉冲能量与内皮细胞密度（r = 0.557；P = 0.011）和平均细胞面积（r = 0.544；P = 0.013）呈正相关。本研究表明，钕:钇铝石榴石激光囊切开术在术后一小时内会导致角膜内皮密度和前房参数立即出现能量依赖性改变。将每次脉冲能量确定为关键决定因素是优化激光参数和减少人工晶状体植入术后患者潜在并发症的初步观察结果。
