Neodymium:YAG laser capsulotomy: a clinical morphological analysis.
BACKGROUND
There are no prospective controlled trials comparing methods of capsulotomy or patterns of capsulotomy openings in similarly graded opacified posterior capsules. This paper aims to investigate the effect of various forms of posterior capsular opacification (PCO) capsulotomy openings on visual function


METHODS
Thirty-six eyes of 34 patients had vision tested and posterior capsules were digitally photographed. Each patient then underwent Nd:YAG laser capsulotomy. Patients returned 1 week later for repeat vision tests and photography. Analyses of areas of pearls and fibrosis were performed using the EPCO software system. Analyses of size and shape of capsulotomy was also done with image analysis software. The capsulotomy characteristics were analysed with respect to improvements in vision, taking into consideration the PCO scores.


RESULTS
No correlation was found between capsulotomy dimensions and visual function improvement, even when PCO details were included in the analyses. Neither capsulotomy area, eccentricity, nor shape irregularity in the ranges measured was found to correlate significantly with eventual visual outcome in terms of contrast sensitivity, near and distance visual acuity, or glare readings.


CONCLUSIONS
Performing a small capsulotomy (at least 1.5 mm in diameter), even if decentred up to 1 mm, may allow for satisfactory visual performance as long as the aperture is clear and not obscured by residual strands.
Aslam
Tariq Mehmood
TM
Department of Ophthalmology, Eye Pavilion, University of Edinburgh, Edinburgh, EH3 9HA, UK. taslam@aol.com
Dhillon
Baljean
B
D002387:Cataract Extraction / Q000009:adverse effects; D015350:Contrast Sensitivity / Q000502:physiology; D019466:Glare; D006801:Humans; D053685:Laser Therapy / Q000379:methods*; D007903:Lens Capsule, Crystalline / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery*; D011183:Postoperative Complications / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery*; D014792:Visual Acuity / Q000502:physiology