Visual Outcomes, Intraocular Pressure Changes, and Complications Following Nd:YAG (Neodymium-Doped Yttrium Aluminum Garnet) Laser Posterior Capsulotomy for Posterior Capsular Opacification: A Prospective Clinical Study

Abstract

Aims and backgrounds Posterior capsular opacification (PCO) is the most common long-term complication after cataract surgery. It leads to decreased contrast sensitivity, distracting glare, and impaired vision. The neodymium-doped yttrium aluminum garnet (Nd:YAG) laser posterior capsulotomy is the de facto standard for non-invasive treatment of visually significant PCO. It enables rapid vision recovery and is considered a gold standard procedure. Nevertheless, complications including increased intraocular pressure (IOP), cystoid macular edema (CME), and retinal detachment are possible following the procedure. Methods Prospective observational research was done at a tertiary care center in Vadodara, Gujarat. Patients with PCO undergoing Nd:YAG laser capsulotomy were included based on defined inclusion and exclusion criteria. Intraocular pressure (IOP), slit lamp examination, dilated fundus examination, uncorrected and best-corrected visual acuity (UCVA, BCVA), and intraocular pressure (IOP) were all part of the pre- and post-procedure measurements. Complications such as CME, retinal detachment, iritis, and IOP rise were recorded. The relationship between total laser energy used and IOP changes was also assessed. Results Most patients achieved rapid, significant visual improvement. Transient IOP elevations were infrequent and medically manageable, with higher risks linked to increased cumulative laser energy. Severe complications like CME were rare. Conclusion Nd:YAG laser capsulotomy is a safe, effective outpatient procedure. Optimal energy settings and post-operative monitoring are vital to maximize recovery and minimize complications. Clinical significance To ensure optimal outcomes and minimize risks, clinicians should use the minimum effective laser energy, ensure precise focusing, and routinely monitor post-procedural intraocular pressure.