Neodymium:YAG Lasers

Stark, Walter J.; Worthen, David M.; Holladay, Jack T.; Murray, George

doi:10.1016/s0161-6420(85)34051-4

Cited by 177 publications

(66 citation statements)

References 2 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Review of literature showing relation between IOP rise and total 17 Kraff et al, 18 Dawood Z et al, 19 Holwegar RR, 20 Mahtab AK et al 21 who noted that there is no statistically significant linear correlation between the rise of IOP and total energy used. In contrast to our study significant correlation was found between IOP elevation and energy used by Stark et al, 22 Mohammad W et al, 23 Channell MM et al 14 who postulated that higher energy levels tend to cause higher rise in IOP (Table 5). …”

Section: Discussioncontrasting

confidence: 95%

See 1 more Smart Citation

To evaluate the effects of Nd:YAG laser posterior capsulotomy on best corrected visual acuity (bcva) and intraocular pressure

Patel¹,

Chandrakar²,

Bajaj³

et al. 2017

Asian J Med Sci

View full text Add to dashboard Cite

A B S T R A C T ORIGINAL ARTICLE ASIAN JOURNAL OF MEDICAL SCIENCESBackground: Nd: YAG laser is non-invasive and effective means to deal with the posterior capsule opacification. However safe it may have some inherent complications. Rise of intraocular pressure is frequently encountered and incompletely understood complication of YAG laser capsulotomy and documented with conflicting results. Aims and Objective: To assess the efficacy of Nd: YAG laser capsulotomy in term of visual outcome(Best Corrected Visual Acuity) and also study the changes in IOP after the procedure. Materials and Methods: Study evaluated the changes in IOP and visual acuity after Nd-YAG laser capsulotomy in 100 eyes with significant PCO after uncomplicated cataract surgery with IOL implantation. Complete ocular examination including visual acuity, anterior segment examination with slit lamp, fundus and applanation tonometry were performed pre and post-laser in all cases. Posterior capsulotomy was done with VISULAS YAG III Q-switched Nd: YAG laser machine by ZEISS. IOP was recorded before and then at 1hour, 1 Day, 1 week and 1 month post-laser in order to determine the IOP changes. Results: Pre-laser visual acuity ranged from 1/60 to 6/12. Results showed statistically significant improvement in BCVA with 70% patients had BCVA 6/6, 21% had BCVA 6/9 and 8% having BCVA 6/12 post-laser at 1 month. It was observed that 36% of the patients showed no change in IOP while 64% patients showed elevated IOP. Among these 59% patients show rise in IOP that was ≤5 mm Hg while only 5% of the patients had a rise of more than IOP >5 mm Hg. Most of these patients achieved their baseline IOP within 1 day and only 7 % patient had rise in IOP compared to baseline IOP on day 1. None of the patients show elevated IOP after 1 week. Conclusion: Our study showed that Nd: YAG laser posterior capsulotomy provided excellent results in terms of visual improvement and most of the patients had a rise of <5mm Hg which was transient in nature and routine antiglaucoma medication may not be needed in all the patient undergoing Nd:YAG capsulotomy, however caution should be exercised in glaucomatous, aphakic, high myopic and other high risk patients.

show abstract

Section: Discussioncontrasting

confidence: 95%

“…22,[24][25][26] In our study there was iritis in 10% patients and lens pitting in 6%. corneal damage, hyphaema, cystoid macular edema, retinal detachment and endophthalmitis were not seen in our study (Table 6).…”

Section: Discussionmentioning

confidence: 78%

To evaluate the effects of Nd:YAG laser posterior capsulotomy on best corrected visual acuity (bcva) and intraocular pressure

Patel¹,

Chandrakar²,

Bajaj³

et al. 2017

Asian J Med Sci

View full text Add to dashboard Cite

show abstract

“…137 Early large case series (n = 2110) supported the effectiveness of the Nd:YAG laser procedure, with 98% of procedures successfully opening the posterior capsule. 138 VA was dramatically improved in 84% of cases, with 81% improved to at least 20/40 vision. 138 In a second case series (n = 595), VA improved by at least two Snellen lines in 75% of cases at 6-12 months after the procedure.…”

Section: Overview Of Capsulotomymentioning

confidence: 91%

“…138 VA was dramatically improved in 84% of cases, with 81% improved to at least 20/40 vision. 138 In a second case series (n = 595), VA improved by at least two Snellen lines in 75% of cases at 6-12 months after the procedure.…”

Section: Overview Of Capsulotomymentioning

confidence: 91%

“…Postoperative complications included (1) raised intraocular pressure -39% of cases experienced a > 5-mmHg increase in pressure 2-6 hours after the procedure and in 28% of cases the pressure was greater than 30 mmHg; 1% of cases had persistent elevation of pressure at 3-6 months -(2) other, rarer, postoperative complications such as cystoid macular oedema, retinal detachment, pupillary block glaucoma, retinal haemorrhage, iritis and vitritis (which occurred in up to 1.2% of cases). 138 Improved cataract surgery and capsulotomy techniques have reduced the incidence of many of these complications. 141 To further minimise these risks the Royal College of Ophthalmologists (RCOphth) guidelines recommend the use of minimal laser energy to avoid pitting the IOL and note that some clinicians routinely give a hypotensive agent immediately after treatment.…”

Section: Overview Of Capsulotomymentioning

confidence: 99%

See 1 more Smart Citation

Using clinical practice variations as a method for commissioners and clinicians to identify and prioritise opportunities for disinvestment in health care: a cross-sectional study, systematic reviews and qualitative study

Hollingworth

Rooshenas

Busby

et al. 2015

Health Services and Delivery Research

View full text Add to dashboard Cite

BackgroundNHS expenditure has stagnated since the economic crisis of 2007, resulting in financial pressures. One response is for policy-makers to regulate use of existing health-care technologies and disinvest from inefficiently used health technologies. A key challenge to disinvestment is to identify existing health technologies with uncertain cost-effectiveness.ObjectivesWe aimed to explore if geographical variation in procedure rates is a marker of clinical uncertainty and might be used by local commissioners to identify procedures that are potential candidates for disinvestment. We also explore obstacles and solutions to local commissioners achieving disinvestment, and patient and clinician perspectives on regulating access to procedures.MethodsWe used Hospital Episode Statistics to measure geographical variation in procedure rates from 2007/8 to 2011/12. Expected procedure numbers for each primary care trust (PCT) were calculated adjusting for proxies of need. Random effects Poisson regression quantified the residual inter-PCT procedure rate variability. We benchmarked local procedure rates in two PCTs against national rates. We conducted rapid systematic reviews of two high-use procedures selected by the PCTs [carpal tunnel release (CTR) and laser capsulotomy], searching bibliographical databases to identify systematic reviews and randomised controlled trials (RCTs). We conducted non-participant overt observations of commissioning meetings and semistructured interviews with stakeholders about disinvestment in general and with clinicians and patients about one disinvestment case study. Transcripts were analysed thematically using constant comparison methods derived from grounded theory.ResultsThere was large inter-PCT variability in procedure rates for many common NHS procedures. Variation in procedure rates was highest where the diffusion or discontinuance was rapidly evolving and where substitute procedures were available, suggesting that variation is a proxy for clinical uncertainty about appropriate use. In both PCTs we identified procedures where high local use might represent an opportunity for disinvestment. However, there were barriers to achieving disinvestment in both procedure case studies. RCTs comparing CTR with conservative care indicated that surgery was clinically effective and cost-effective on average but provided limited evidence on patient subgroups to inform commissioning criteria and achieve savings. We found no RCTs of laser capsulotomy. The apparently high rate of capsulotomy was probably due to the coding inaccuracy; some savings might be achieved by greater use of outpatient procedures. Commissioning meetings were dominated by new funding requests. Benchmarking did not appear to be routinely carried out because of capacity issues and concerns about data reliability. Perceived barriers to disinvestment included lack of collaboration, central support and tools for disinvestment. Clinicians felt threshold criteria had little impact on their practice and that prior approval systems would not be cost-effective. Most patients were unaware of rationing.ConclusionsPolicy-makers could use geographical variation as a starting point to identify procedures where health technology reassessment or RCTs might be needed to inform policy. Commissioners can use benchmarking to identify procedures with high local use, possibly indicating overtreatment. However, coding inconsistency and limited evidence are major barriers to achieving disinvestment through benchmarking. Increased central support for commissioners to tackle disinvestment is needed, including tools, accurate data and relevant evidence. Early engagement with patients and clinicians is essential for successful local disinvestment.FundingThe National Institute for Health Research Health Services and Delivery Research programme.

show abstract

Long-term Effect of Nd:YAG Laser Posterior Capsulotomy on Intraocular Pressure

Ge¹,

Wand²,

Chiang³

et al. 2000

Arch Ophthalmol

View full text Add to dashboard Cite

To study the long-term effect of Nd:YAG capsulotomy on intraocular pressure (IOP). Methods: We reviewed the records of patients with bilateral pseudophakia who received Nd:YAG capsulotomy in only 1 eye. Using the Wilcoxon rank sum test, we compared the mean change in IOP in eyes before and after capsulotomy with that of the noncapsulotomy eyes at corresponding time intervals. Using multiple regression tests, we analyzed the factors significantly associated with postcapsulotomy long-term IOP increases. Results: The study included 100 patients who were followed up for a median of 1.5 years after capsulotomy. The mean ± SD age of the study group was 76±7 years, and 37 patients had glaucoma. The changes in IOP in the

show abstract

Neodymium:YAG Lasers

Cited by 177 publications

References 2 publications

To evaluate the effects of Nd:YAG laser posterior capsulotomy on best corrected visual acuity (bcva) and intraocular pressure

To evaluate the effects of Nd:YAG laser posterior capsulotomy on best corrected visual acuity (bcva) and intraocular pressure

Using clinical practice variations as a method for commissioners and clinicians to identify and prioritise opportunities for disinvestment in health care: a cross-sectional study, systematic reviews and qualitative study

Long-term Effect of Nd:YAG Laser Posterior Capsulotomy on Intraocular Pressure

Contact Info

Product

Resources

About