Factors Affecting IOP Changes Following Neodymium: Yttrium Aluminum GARNET (Nd:YAG) Capsulotomy

Abstract

Introduction: Transient intraocular pressure rise is a commonly observed phenomenon following Nd:YAG capsulotomy. However, IOP change is considered to be dependent on multiple factors. Study aimed to assess factors determining the IOP change following Nd:YAG capsulotomy. Material and Methods: A total of 150 adult patients, scheduled to undergo Nd:YAG laser capsulotomy for management of posterior chamber opacification (PCO) were enrolled. Age, gender, time since cataract surgery, PCO grade, IOP, topical hypotensive use was noted in all the cases. Amount of energy used in Nd:YAG procedure was recorded. Postoperative IOP change was noted immediately, 1 hr and 3 hr postoperative intervals. Rise >5 mm was considered clinically significant. Independent samples 't'-test, Chi-square test and binary logistic regression were used. Data analysis was performed using SPSS 15.0 software. Results: Mean age of patients was 60±11.3 years. Majority were females (59.3%). Majority of patients had Grade I and II of PCO (64%), 5-10 years duration since cataract surgery (79.3%) and topical hypotensive use was done(58%). Preoperative mean IOP was 15.99±2.72 mmHg. Energy used was 55.7±52.7 mJ. A total of 19 (12.7%) patients had IOP rise >5 mm. On univariate analysis, Grade III or above PCO, higher level of total energy use and low hypotensive use were found to be significantly associated with IOP rise. On multivariate assessment, low hypotensive use and high energy use were found to be significantly associated with clinically significant IOP rise (p<0.05). Conclusions: Low energy and prophylactic topical hypotensives were protective against IOP rise.