Posterior vitreous detachment after neodymium:YAG laser posterior capsulotomy.
OBJECTIVE
To determine whether retinal detachment (RD) after neodymium:YAG (Nd:YAG) laser posterior capsulotomy is due to a greater incidence of posterior vitreous detachment (PVD) than in controls and whether vitreous status at the time of capsulotomy is useful in predicting the risk for RD.


METHODS
Teaching hospital ophthalmology service.


METHODS
Patients having Nd:YAG laser posterior capsulotomy after uneventful cataract surgery (treatment group) were prospectively studied. Fellow eyes that had extracapsular cataract extraction (ECCE) with intraocular lens (IOL) implantation but no Nd:YAG capsulotomy (no-laser group) formed 1 control group, and eyes that had no cataract surgery (phakic group) formed a second control group. The treatment group comprised 322 eyes; the no-laser group, 97; and the phakic group, 142. Dilated fundus and vitreous examinations were performed at baseline (before Nd:YAG capsulotomy) and 12 months postoperatively.


RESULTS
At baseline, the prevalence of PVD was similar in the treatment and no-laser groups (61.8% and 63.9%, respectively; P=.2014) but was significantly lower in the phakic group (50.7%; P=.0151). There was no significant difference among the groups in the development of PVD in eyes with attached vitreous at baseline (17.9%, treatment group; 11.4%, no-laser group; 17.1%, phakic group) (P=.6588).


CONCLUSIONS
The prevalence of PVD was significantly higher in eyes after ECCE and IOL implantation than in phakic eyes independent of Nd:YAG laser posterior capsulotomy. Capsulotomy was not associated with a significantly higher incidence of new PVD; therefore, the presence or absence of PVD at the time of capsulotomy is not helpful in assessing the risk for RD in the first year after laser treatment.
Sheard
Richard M
RM
Vitreoretinal Service, Department of Ophthalmology, Addenbrooke's Hospital, Hills Road, Cambridge CB2 2QQ, United Kingdom.
Goodburn
Sandy F
SF
Comer
Marie B
MB
Scott
John D
JD
Snead
Martin P
MP
D000368:Aged; D002387:Cataract Extraction; D005260:Female; D006801:Humans; D053685:Laser Therapy / Q000009:adverse effects*; D007903:Lens Capsule, Crystalline / Q000601:surgery*; D019654:Lens Implantation, Intraocular; D008297:Male; D011183:Postoperative Complications / Q000601:surgery*; D015995:Prevalence; D011446:Prospective Studies; D019591:Pseudophakia / Q000150:complications; D012163:Retinal Detachment / Q000453:epidemiology / Q000209:etiology; D012307:Risk Factors; D020255:Vitreous Detachment / Q000453:epidemiology / Q000209:etiology*