Amin Shaikh, Altaf H Shaikh, Rahman Shaikh, Khalid R Shaikh, Amanullah Shaikh.
Visual Outcome & Complications of Nd: Yag Laser Posterior Capsulotomy, an Experience at Chandka Medical College Hospital, Larkana.
Ophthalmol Update Jan ;13(4):279-82.

Aims of Study: Neodymium: Yttrium Aluminium Garnet (Nd: YAG) laser is used in the treatment of posterior capsule opacification (PCO) to improve visual acuity. PCO causes significant reduction in visual acuity in patients who had cataract surgery. This study is aimed at determining the visual outcome and complications of patients who received Nd: YAG laser application following PCO. Visual out come and complications of Nd: YAG laser posterior capsulotomy; an experience at CMC Hospital Larkana. Study Design: Prospective observational study. Place and Duration: Department of Ophthalmology Chandka Medical College Civil Hospital Larkana from March 2011 to March 2013. Patients and Methods: The study comprises 500 patients selected from OPD from March 2011 to March 2013, who underwent Nd: YAG laser posterior capsulotomy. Abraham capsulotomy contact lens was placed onto the eye. The aiming beam was focused on the posterior capsule 1 mm inside the IOL edge. Nd: YAG laser was applied to create an opening in the posterior capsule. Result: In this study there were 260 males and 240 females with mean age of 61.4 years. The mean duration between cataract surgery and capsulotomy was 1.4 years. At last follow up the visual acuity improved in 86.3 % cases. There was marked improvement in the best corrected visual acuity after laser application, (61.8%) cases had visual acuity of 6/9 to 6/6. (33.2%) cases had visual acuity of 6/18 or better after 4 weeks of laser application. Only 16 (3.2%) eyes had visual acuity of 6/24 and 9 (1.8%) eyes had visual acuity of less than 6/60. These patients were suffering from age related macular degeneration. Mean laser shots applied were 22.3 (SD=6.5) with a mean power 1.3 ml SD (.04). Acute complications in first week included bleeding from iris, pitting to the IOL, hanging flap, transient rise in intraocular pressure, transient anterior chamber reaction, cystoid macular edema which resolved over a period of six months. Retinal detachment was noted in six cases after a period of at least Two years follow up. Conclusion: Nd: YAG laser posterior capsulotomy is a safe and effective procedure with good visual outcome which can be adopted by skilled ophthalmologists without any significant harm to the patients.

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