Late-Onset Elevation in Intraocular Pressure After Neodymium-YAG Laser Posterior Capsulotomy

Fourman, Stuart; Apisson, John

doi:10.1001/archopht.1991.01080040079031

Cited by 45 publications

(17 citation statements)

References 9 publications

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“…The results of this study question this view. They rather support an idea that was put forward by other studies which raised the question whether Nd: YAG capsulotomy could cause persistent glaucoma [10,[22][23][24].…”

Section: Discussionsupporting

confidence: 67%

“…One reason is probably the small size of the eleva tion in IOP that Nd:YAG seems to cause in most patients. Most long-term studies asked what the incidence o f glauco ma was following Nd:YAG capsulotomy [10,22], Conse quently, changes o f IOP occurring in patients not develop ing glaucoma were not examined in detail. Another reason seems to be the methodology used in these studies.…”

Section: Discussionmentioning

confidence: 99%

“…The advent of Nd: YAG capsu-lotomy has greatly improved the treatment o f secondary cat aract. The acute rise in IOP, developing in the immediate postoperative period, is a complication which occurs fre quently after Nd:YAG capsulotomy [10][11][12][13][14][15]. IOP rises more often in aphakic eyes than in pseudophakic eyes [15,16], It can be effectively treated by topical or systemic drug ther apy [17 19].…”

Section: Introductionmentioning

confidence: 99%

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Long-Term Elevation of Intraocular Pressure after Neodymium: YAG Laser Posterior Capsulotomy

Jahn¹,

Emke²

1996

Ophthalmologica

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Uncomplicated extracapsular cataract extraction (EC) followed by posteriorchamber lens implantation (PCL) has been shown to cause long-term lowering of intraocular pressure (IOP) in most patients. Since it has been suggested that Neodymium: YAG (Nd:YAG) laser capsulotomy can provoke persistent glaucoma, we examined the hypothesis that Nd: YAG laser capsulotomy may lead to a permanent elevation of IOP. In a case-control study, we compared two groups of 75 normotensive patients, who were unilaterally pseudophakic after phacoemulsification (PE) + PCL. Patients in group 1 had undergone NdYAG capsulotomy at least 2 months prior to this study, while in group 2 the posterior capsule was intact. Both groups were selected at random. Prior to surgery, none of the patients had suffered from glaucoma. Goldmann applanation tonometry was performed in both eyes of each patient and from that the ratio of IOP_pseudophakic/IOP_phakic was calculated. The distribution of this ratio for the two groups was compared using the Wilcoxon signed-rank test. There were 52 female and 23 male patients in group 1 versus 56 female and 19 male patients in group 2. Their mean ages were 75+11 (group 1) and 75 ± 9 years (group 2). The mean interval after PE + PCL was 48 ± 29 months for patients with Nd:YAG capsulotomy and 16 ± 17 months for patients with intact posterior capsule. Since the Nd:YAG capsulotomy, 28 ± 23 months had elapsed on average. The median ratio of IOP_pseudophakic/IOP_phakic was higher in the Nd: YAG capsulotomy group than in the group of patients with an intact posterior capsule (1.00 vs. 0.80; p < 0.0001). There was almost no percentile, for which the distribution curve of group 1 intersected the curve of group 2. The median IOP in pseudophakic eyes was 14 mm Hg in group 1 and 12 mm Hg in group 2 (p < 0.0001). These results are in accordance with the hypothesis that Nd: YAG capsulotomy will raise IOP permanently in most patients. Therefore NdYAG capsulotomy may harbor the risk of glaucomatous optic nerve damage in the long run. Long-term follow-up seems advisable in order to prevent possible glaucoma damage.

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Section: Discussionsupporting

confidence: 67%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Long-Term Elevation of Intraocular Pressure after Neodymium: YAG Laser Posterior Capsulotomy

Jahn¹,

Emke²

1996

Ophthalmologica

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“…Similarly in a study done by Stuart Fourman et al [21], they showed transient rise in IOP just after laser along with long term elevation in IOP. In our study there was elevation in IOP at two hours in all the three groups as well as on inter group comparison the change was statistically significant.…”

Section: Discussionmentioning

confidence: 52%

The Effects of Different Techniques and Energy Used in Nd: Yag Laser Posterior Capsulotomy on Intraocular Pressure: A Prospective Study

Fahim¹

2017

Austin J Clin Ophthalmol

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Purpose: To study the relationship between energy used and its effect on IOP in different capsulotomy techniques i.e. cruciate, circular and inverted 'u'. Subjects and Methods:The study was conducted in 154 patients from the out patients department who fulfilled the inclusion criteria and developed posterior capsular opacification following successful cataract surgery. And the patients were randomly divided into three groups. Group I undergoing cruciate technique, group II undergoing circular technique and group III undergoing inverted U technique. Preprocedure intraocular pressure was recorded by using applanation tonometry. Patients undergoing Nd: Yag laser capsulotomy were seen after 2 hours, 1 day, 1week, 1 month and 3 months and IOP was recorded. The outcome was measured in terms of number of shots given in the technique, total energy used and intra ocular pressure changes after the laser. Results:In the light of our present study, we have found that group II which is circular technique group consumes higher no. of laser shots and higher amount of total laser energy which leads to transient rise in intraocular pressure. Correlation was found between the IOP readings obtained and amount of total laser energy used. Conclusions:The techniques cruciate and inverted U appears to be better and safer than the circular technique in terms of amount of energy used and the complications associated with it.

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“…Visual acuity can be restored by neodymium-YAG laser posterior capsulotomy. However, opening the posterior capsule may lead to serious complications, including damage to the intraocular lens (IOL) [6,7], intraocular pressure elevation [8,9], macular edema [10] and retinal detachment [11].…”

Section: Introductionmentioning

confidence: 99%

Development of Posterior Capsule Opacification in the Rabbit

Wallentin

Lundgren²,

Holmén³

et al. 2002

Ophthalmic Res

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Purpose: The aim of the present study was to characterize the development of after-cataract in the rabbit by measuring its wet weight, protein, DNA and glycosaminoglycan (GAG) contents and using Scheimpflug and slitlamp analysis. Further, aqueous humor (AqH) leukocytes, protein and lens epithelial cell proliferation activity were determined. Methods: AqH was collected and capsular bags including after-cataract were dissected free on days 0, 1, 7, 14, 28 and 56 after cataract surgery. The wet weights were determined and the contents of DNA, protein and GAG in the capsular bags including after-cataract were analyzed. AqH was analyzed for leukocytes, protein and proliferative activity. In another set of experiments, rabbit eyes were analyzed by the Scheimpflug technique and slitlamp examination on days 0, 1, 7, 14, 28 and 56 after cataract surgery. The wet weight of the capsular bag with the after-cataract was also determined. Results: An increase was found in the wet weight (480%) and the contents of protein (221%), DNA (945%) and GAG (336%) of the capsular bags including after-cataract during the experimental period. In the AqH, all 3 variables measured, leukocytes, protein and proliferative activity, reached their highest levels on day 1 after surgery. In the second set of experiments, the wet weight of the capsular bag including after-cataract increased by 391% during the 56-day experimental period. Posterior capsule opacification (PCO), as measured by Scheimpflug analysis, increased from 0.8 to 81.7% and the scores of Elschnig’s pearls as well as fibrosis, analyzed by slitlamp, increased from 0.0 to 2.8 and 3.0, respectively. Conclusions: This study shows that the same components that are reported to be important in human PCO are also components of PCO in the rabbit. Thus, the rabbit model seems to accurately reflect human PCO development, and because PCO develops much faster in rabbits that would make the rabbit model suitable for studies to elucidate human PCO development.

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Late-Onset Elevation in Intraocular Pressure After Neodymium-YAG Laser Posterior Capsulotomy

Cited by 45 publications

References 9 publications

Long-Term Elevation of Intraocular Pressure after Neodymium: YAG Laser Posterior Capsulotomy

Long-Term Elevation of Intraocular Pressure after Neodymium: YAG Laser Posterior Capsulotomy

The Effects of Different Techniques and Energy Used in Nd: Yag Laser Posterior Capsulotomy on Intraocular Pressure: A Prospective Study

Development of Posterior Capsule Opacification in the Rabbit

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