VISUAL OUTCOMES AND COMPLICATIONS FOLLOWING Nd: YAG LASER POSTERIOR CAPSULOTOMY IN POSTERIOR CAPSULAR OPACIFICATION: A RETROSPECTIVE STUDY

Dr. B. Karishma Munoli; Dr. Goswami Niraj Nagarpuri; Dr. Ramesh Nadumani

doi:10.65605/a-jmrhs.2026.v04.i01.pp721-728

Authors

Dr. B. Karishma Munoli Associate Professor, Department of Ophthalmology, Raichur Institute of Medical Sciences, Raichur. Author
Dr. Goswami Niraj Nagarpuri Junior Resident, Department of Ophthalmology, Raichur Institute of Medical Sciences, Raichur. Author
Dr. Ramesh Nadumani Senior Resident, Department of Ophthalmology, Raichur Institute of Medical Sciences, Raichur. Author

DOI:

https://doi.org/10.65605/a-jmrhs.2026.v04.i01.pp721-728

Keywords:

Posterior Capsular Opacification, Nd:YAG Laser Capsulotomy, Visual Outcomes, Intraocular Pressure, Complications, Cystoid Macular Edema.

Abstract

Background: Posterior capsular opacification (PCO) is the most common long-term complication following cataract surgery, affecting 20-40% of patients within five years. Nd:YAG laser posterior capsulotomy is the definitive treatment for symptomatic PCO. This study aimed to evaluate visual outcomes and document the spectrum of complications following Nd:YAG laser capsulotomy at a tertiary care center serving a predominantly rural population. Methods: A retrospective observational study was conducted from December 2023 to March 2025 (16 months). A total of 123 eyes with clinically significant PCO following uneventful cataract surgery underwent Nd:YAG laser posterior capsulotomy. Pre-procedure and post-procedure best-corrected visual acuity (BCVA), intraocular pressure (IOP), laser parameters, and complications were analyzed. Follow-up was performed at immediate, 1 hour, day 1, week 1, week 4, and week 6 post-procedure. Results: The mean age was 62.47±9.86 years with female predominance (54.5%). Mean duration since cataract surgery was 26.84±14.62 months. Visual acuity improved significantly from 0.58±0.24 logMAR pre-procedure to 0.18±0.14 logMAR at 6 weeks (p<0.001), with 91.1% achieving improvement of ≥2 Snellen lines. Transient IOP elevation (>5mmHg) occurred in 26.8% at 1 hour, normalizing in 93.9% within 24 hours. Complications included anterior uveitis (15.4%), IOL pitting (4.9%), cystoid macular edema (2.4%), and no cases of retinal detachment. Mean total laser energy was 86.24±32.46 mJ. Higher total energy (>100mJ) was significantly associated with increased complication rates (p=0.008). Conclusion: Nd:YAG laser posterior capsulotomy is a safe and effective treatment for PCO with excellent visual outcomes. Using lower total energy and performing smaller capsulotomies minimize complications. Prophylactic IOP-lowering medication and close monitoring are recommended post-procedure.