To evaluate the changes in intraocular pressure and macular thickness after Nd: Yag laser posterior capsulotomy.
Methodology: This prospective study included 91 eyes of 78 patients who were diagnosed as posterior capsule opacification (PCO), following uncomplicated cataract surgery. All the patients were examined preoperatively and 1 hour post-procedure, 1 week and 4 weeks after Nd: YAG capsulotomy. IOP and macular thickness of all the patients was measured by Goldmann applanation tonometry and optical coherence tomography (OCT), respectively before performing the procedure and at subsequent visits. Patients were divided into two groups based on energy used (Group I ≤50 mJ, Group II >50 mJ). None of the patients received prophylactic antiglaucoma medications either before or after the procedure.
Results: There were 42 males and 36 female patients included in the study. Mean age of the patients was 53.87 ± 10.24 years (45-80 years). Mean total energy levels were 38.64±13.92 mJ in Group I and 85.76±22.10 mJ in Group II. In Group I, IOP did not increase at 1 hour postoperatively (P=0.063) and was within normal limits at 1 week and 4 weeks. In Group II, IOP increased at 1 hour postoperatively (P<0.001) and did not return to preoperative levels at 1-week follow-up (P=0.003). Likewise, macular thickness increased at 1 hour in group II (P<0.001). In Group I, macular thickness was normal at 1 week follow up whereas in Group II, it remained significantly high at 1-week follow-up (P=0.006). There was no case with serious rise in IOP or cystoid macular edema. However, at subsequent follow-up intervals, the difference between the IOP and macular thickness between two groups was not significant statistically.
Conclusion: Nd-YAG laser capsulotomy causes rise in IOP and macular thickness which can sustain up to a substantial period. The amount of energy used in Nd: YAG laser posterior capsulotomy is significantly correlated to rise in IOP and increased macular thickness.