Impact of Nd-YAG Laser Capsulotomy on Visual Acuity and Intraocular Pressure
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Background: Posterior capsular opacification is a common problem after cataract surgery that causes blurred vision. Nd-YAG laser capsulotomy is used to improve vision, but its effects on visual acuity and short-term changes in eye pressure need evaluation. Objective: To evaluate the impact of Nd-YAG laser capsulotomy on visual acuity and intraocular pressure. Methodology: A comparative cross-sectional study was conducted from October to December 2023 at the College of Ophthalmology and Allied Vision Sciences, Mayo Hospital, Lahore. A convenience sampling technique was used to recruit 40 patients aged 50 years, and posterior capsular opacification with reduced visual acuity was included in this study. The patients having corneal diseases, retinal diseases, diabetic retinopathy, glaucoma, and any other pathology were excluded. Before performing any test, the procedure was explained, and informed consent was taken. Visual acuity was measured and recorded using an ETDRS chart both prior to and following a 30-minute YAG laser capsulotomy. Intraocular pressure was then assessed using a non-contact air puff tonometer, and the results showed that intraocular pressure values greater than 20mmHg suggest a post-laser spike in intraocular pressure. The mean and standard deviation were used to calculate quantitative variables, whereas frequency and percentages were used to quantify qualitative factors. The Wilcoxon Signed Ranks test was used to compare pre-procedure and post-procedure results. Results: All patients initially had visual acuity 1.0 log MAR, with 37 having intraocular pressure 10-21mmHg and 3 having intraocular pressure <10mmHg. After 30 minutes, visual acuity improved significantly in all patients, while post-intraocular pressure and p-values did not show significant results. The comparison between 30 minutes and 15 days was statistically significant for both intraocular pressure and visual acuity (p<0.001). Overall, the results showed improvement in visual acuity with a temporary rise in intraocular pressure. Conclusion: Post-laser visual acuity was enhanced, and intraocular pressure elevation in severe posterior capsular opacification appeared to be a transient phenomenon that was linked to the mechanical energy and laser shots administered during the procedure.
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