The research has been done in Alassad University Hospital in Lattakia, from January 2009 to January 2011 and included 80 pseudophakic eyes of 80 patients ] 36 (45.0%) belonged to male sex and 44 (55.0%) females[ older than 15 years having PCO with
decreased best corrected Visual Acuity (VA) of two or more Snellen’s chart line. Before laser treatment, the VA was assessed and all patients were examined on slit lamp for IOP and to rule out the causes for reduced vision other than PCO. Then 2-3 mm size capsulotomy was done with Q-switched Nd: YAG Laser, with Abraham’s posterior capsulotomy lens, after topical anesthesia, by using minimum amount of energy and fewest numbers of pulses. Patients were followed for assessment of best corrected VA and for possible complications just after laser and at the end of 1st week, 2nd week and the 4th week. The post-laser treatment was advised in accordance with complications to each patient.
The types of PCO were fibrosis in 54 (67.5%) eyes, Elschnig pearls in 16 (20 %) eyes and wrinkling in 10 (12.5%) eyes. Pre-laser visual acuity was CF-6/60 in 42 (52.5%) eyes, 6/36-6/24 in 23 (28.75%) eyes and 6/18-6/12 in 15 (18.75%) eyes. Post-laser VA was improved to 6/9-6/6 in 60 (75%) eyes. Out of 80 patients, 10 (12.5%) eyes developed the complications due to YAG laser which included IOL pitting in 4 (5%) eyes, raised IOP in 1 (1.25%), uveitis in 2 (2.5%), iris bleeding (hyphema) in 1 (1.25%), vitreous in anterior chamber in 1 (1.25%), and cystoids macular edema (CME) in 01(1.25%) eye. None of the eye developed sight threatening complications like retinal detachment or macular hole. The 20 (25%) eyes did not achieve the significant improvement because of pre-existing pathology in the posterior segment that was not diagnosed at the time of screening due to thick PCO.
This means that Nd: YAG laser capsulotomy is effective and convenient method for doing capsulotomy in all types of PCO. It is free from the risk of endophthalmitis found in surgical capsulotomy.
