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      Angle-closure glaucoma associated with vitreous prolapse after neodymium-doped yttrium-aluminum-garnet laser posterior capsulotomy

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          Abstract

          ABSTRACT Capsulotomy with neodymium-doped yttrium--aluminum-garnet (Nd:YAG) laser is an effective treatment for posterior capsule opacification following cataract surgery. A wide opening of the posterior capsule associated with the ruptured anterior hyaloid can cause anterior chamber vitreous prolapse. Two patients who developed angle-closure glaucoma associated with vitreous prolapse following Nd:YAG laser posterior capsulotomy were successfully treated with antiglaucoma medication and peripheral iridotomies. Patient identification for potential risk factors and a careful postoperative follow-up are essential to avoid these serious complications.

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          Posterior capsular opacification: a problem reduced but not yet eradicated.

          Suqin Guo, NIRANJAN AWASTHI, B. Wagner (2009)
          Posterior capsular opacification (PCO) is the most frequent complication of cataract surgery. Advances in surgical techniques, intraocular lens materials, and designs have reduced the PCO rate, but it is still a significant problem. The only effective treatment for PCO, Nd:YAG laser capsulotomy carries vision-related complications and risks and puts a significant financial burden on the health care system. This review contains current knowledge about the mechanisms of PCO development. Posterior capsular opacification is caused mainly by remnant lens epithelial cell proliferation and migration, epithelial-mesenchymal transition, collagen deposition, and lens fiber generation. All of these processes are influenced by cytokines, growth factors, and extracellular matrix proteins. We also describe advances and improvements in surgical techniques, intraocular lens materials, and the designs and use of therapeutic agents leading to safe, effective, and less expensive strategies to eradicate PCO.
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            Intraocular pressure changes after neodymium-YAG laser posterior capsulotomy.

            H T Beckman, Meghan M Channell (1984)
            Thirty-seven Q-switched neodymium-YAG laser posterior capsulotomies were performed on 33 aphakic or pseudophakic eyes. The average intraocular pressure increase during the first 24 hours after treatment was 12.0 +/- 6.9 mm Hg from a baseline value of 17.7 mm Hg in the treated eye v +0.7 +/- 3.5 mm Hg in the untreated eye. Seven eyes had larger capsulotomies performed, averaging 250.7 millijoules (mJ) of energy per treatment. Thirty eyes had smaller posterior capsulotomies performed, averaging 48.3 mJ per treatment. Average IOP increases within the first day were 16.1 and 12 mm Hg, respectively. All eyes in which IOP increased more than 5 mm Hg showed the increase within the first 48 hours. In some eyes, IOP remained elevated more than 10 mm Hg above preoperative levels for several weeks. Higher pressures were associated with larger capsulotomies and increased energy. Minimizing debris and shock waves are recommended as well as thorough postoperative pressure monitoring.
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              The effect of Nd:YAG laser treatment of posterior capsule opacification on anterior chamber depth and refraction in pseudophakic eyes

              Bharkbhum Khambhiphant, Chayata Liumsirijarern, Piyada Saehout (2015)
              Purpose This was a prospective descriptive study to determine the changes in intraocular lens (IOL) position after neodymium-doped yttrium–aluminum–garnet (Nd:YAG) laser posterior capsulotomy by measuring anterior chamber depth (ACD) and refraction, including the spherical equivalent (SE) and cylinder. Materials and methods Forty-seven pseudophakic eyes with posterior capsule opacification of 29 patients were included. Nd:YAG laser posterior capsulotomy was performed. Patients’ ACD and refraction were measured before the treatment, as well as after the treatment at 1 week and 3 months. IOLMaster® and an automated refractometer were used at the Department of Ophthalmology, King Chulalongkorn Memorial Hospital, Bangkok, Thailand. Results There were no statistically significant differences in ACD and SE before and after laser treatment at 1 week and 3 months (repeated analysis of variance, P=0.582 and P=0.269, respectively). Both backward IOL movement (number [n]=29) and forward IOL movement (n=18) were found. Some changes in cylindrical refraction were found at 1 week, but decreased at 3 months after capsulotomy (baseline cylinder: −1.16; cylinder at 1 week and 3 months: −1.00 and −1.14, respectively; P=0.012). These changes were the same with one-piece and three-piece IOLs. Conclusion Nd:YAG laser posterior capsulotomy did not significantly change ACD and SE. It led to cylinder change at 1 week after laser, but the effect decreased at 3 months. This effect was small and may not be clinically significant.
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                Author and article information

                Journal
                Journal ID (publisher-id): abo
                Title: Arquivos Brasileiros de Oftalmologia
                Abbreviated Title: Arq. Bras. Oftalmol.
                Publisher: Conselho Brasileiro de Oftalmologia (São Paulo, SP, Brazil )
                ISSN (Print): 0004-2749
                ISSN (Electronic): 1678-2925
                Publication date (Print and electronic): 2024
                Volume: 87
                Issue: 2
                Electronic Location Identifier: e2022-0058
                Affiliations
                [1] Fortaleza CE orgnameFundação Leiria de Andrade Brazil
                [3] Fortaleza CE orgnameFundação de Ciência e Pesquisa Maria Ione Xerez Vasconcelos Brazil
                [2] São Paulo orgnameUniversidade Federal de São Paulo Brazil
                [4] Ribeirão Preto orgnameUniversidade de São Paulo orgdiv1Faculdade de Medicina de Ribeirão Preto orgdiv2Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery Brazil
                Article
                Publisher ID: S0004-27492024000200500 Publisher ID: S0004-2749(24)08700200500
                DOI: 10.5935/0004-2749.2022-0058
                SO-VID: dc07264a-82f7-4829-8d31-33711f169cb2
                License:

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                Date accepted : 25 April 2023
                Date received : 07 February 2022
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 10, Pages: 0
                Product

                SciELO Brazil

                Categories
                Subject: Case Report

                Keywords: Cataract,Posterior capsulotomy,Laser,solid-state,Glaucoma,Glaucoma angle closure
                Data availability:
                Keywords: Cataract, Posterior capsulotomy, Laser, solid-state, Glaucoma, Glaucoma angle closure

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