Intraocular Lens Position and Anterior Chamber Parameters Evaluation After Nd:YAG Laser Posterior Capsulotomy for Posterior Capsular Opacification Using Anterior Segment Swept-Source Optical Coherence Tomography

Abstract

Purpose To evaluate the effect of neodymium-doped yttrium aluminum garnet (Nd:YAG) laser capsulotomy on intraocular lens (IOL) position and anterior segment parameters with a new swept-source anterior segment optical coherence tomography (AS-OCT) device (Anterion ® , Heidelberg Engineering GmbH). Patients and Methods A total of 50 eyes from 50 consecutive patients were included. All patients had visually significant posterior capsular opacification (PCO) after uneventful phacoemulsification surgery with manual capsulorhexis and single-piece C-loop acrylic IOL implantation (AcrySof ® SA60AT) and were treated with Nd:YAG laser. Anterior segment images were captured with Anterion ® in non-dilated conditions before and one month after the procedure. In the “Metrics App”, we collected data of the anterior chamber angle (ACA) 3 and 9 o’clock, the anterior chamber depth (ACD), the anterior chamber volume (ACV), and the central corneal thickness (CCT). We also collected demographic and clinical data [age, gender, months from surgery to Nd: YAG capsulotomy, pre- and post-capsulotomy corrected distance visual acuity (CDVA) and spherical equivalent, and axial length]. Results We did not find a statistically significant difference in ACD after the Nd:YAG capsulotomy (3.96 ± 0.55 vs 3.97 ± 0.55 mm, p = 0.10). In 28 patients, we noted a backward movement of the IOL; in the remaining 22, the IOL moved forward or did not change at all. We did not observe significant changes in ACA at the 3 and 9 o’clock reference points, ACV, or CCT. There was an improvement in CDVA after the procedure (0.37 ± 0.21 vs 0.12 ± 0.27 logMAR, p = 0.015), without statistically significant differences in SE (−0.15 ± 0.84 vs −0.25 ± 0,93, p = 0.42). Axial length was not correlated with ACD variations after the procedure (p = 0.67). Conclusion Our results show that Nd:YAG laser capsulotomy does not change the axial position of a single-piece C-loop acrylic IOL inside the capsular bag, as well as other anterior chamber parameters.

Influence of Nd:YAG laser capsulotomy on toric intraocular lens rotation and change in cylinder power

“…4 In addition, they observed that the increase in ACD was positively correlated with capsulotomy size. By contrast, no changes in anteriorsegment parameters (ACD, ACA, ACV) were reported after Nd:YAG laser capsulotomy in 50 eyes with single-piece C-loop acrylic IOL (AcrySof SA60AT, Alcon Laboratories, Inc.) in a study by Joao et al or in 47 eyes with 1-piece and 3piece IOLs in a study by Khambhiphant et al 5,6 In our study, there was a minimally significant increase in ACD at 1 month after capsulotomy in 41 eyes with the acrylic foldable toric single-piece AcrySof IQ IOL. The TIOLs showed posterior movement on the axial plane within the anterior chamber in our study, similar to the behavior of single-piece IOLs in the studies by Findl et al and Khambhiphant et al…”

“…In addition to IOL-related factors such as haptic design (plate or C-loop) and material (hydrophobic or hydrophilic), other factors that affect the stability of in-the-bag IOLs include anterior-segment parameters, capsulorhexis dimensions and shape, the extent of capsule-IOL overlap, the Nd:YAG laser posterior capsulotomy procedure, and posterior capsulotomy size. [3][4][5][6][7] In addition, rotation may occur in the first 10 days after cataract surgery and to a lesser extent in later years. 8 Over time, posterior capsule opacification (PCO) caused by the accumulation of fibrotic material on the posterior capsule leads to decreased vision and undesirable conditions such as halo and glare.…”

Evaluation of Anterior Segment Parameters Using Scheimpflug Topography Device in Patients Undergoing Nd:YAG Laser Posterior Capsulotomy: Retrospective Study

“…3,19,20 Changes in the axial position of the IOL may result in a myopic or hyperopic shift, depending on the direction of displacement. 10,14 In the literature, various studies have explored the effects of Nd:YAG laser capsulotomy on intraocular pressure, refraction, and ACD parameters. In a study conducted by Parajuli et al, they demonstrated that the SE remained stable during the first week and first month after Nd:YAG laser capsulotomy.…”

“…9 While offering visual improvement, it is important to note that the procedure can also be associated with potential complications including sudden intraocular pressure elevation, pitting of the intraocular lens (IOL), uveitis, cystoid macular edema, vitreoretinal separations, and refractive changes caused by axial movement of the IOL as well as IOL dislocation. [10][11][12] Our study aimed to present findings from patients who sought treatment at a tertiary care institution and underwent Nd:YAG laser capsulotomy. While previous studies have mainly focused on the changes in the position of IOL and their refractive status.…”

Stability of neodymium:YAG laser posterior capsulotomy in eyes with capsular tension rings

“…However, there are still CTRinserted eyes with PCO, in which Nd:YAG laser capsulotomy is needed. Nd:YAG laser posterior capsulotomy can change the anterior segment parameter in pseudophakic eyes [14][15][16] . Also, intraocular devices, such as IOL and CTRs, can change the anterior segment parameter and the severity of PCO in pseudophakic eyes [12,17] .…”