Anterior capsule relaxing incisions with neodymium:YAG laser for patients at high-risk for anterior capsule contraction.
OBJECTIVE
To examine the effect of anterior capsule relaxing incisions created with a neodymium:YAG (Nd:YAG) laser on prevention of anterior capsule contraction after cataract surgery in high-risk patients.


METHODS
Hayashi Eye Hospital, Fukuoka, Japan.


METHODS
Randomized masked clinical trials.


METHODS
Patients at high risk for anterior capsule contraction had anterior capsule relaxing incisions in either eye 3 days postoperatively. The anterior capsule opening was measured using a Scheimpflug videophotography system (EAS-1000) immediately and 1, 3, and 6 months after capsulotomy, and the percentage reduction in area was calculated. The degree of intraocular lens (IOL) decentration and tilt, posterior capsule opacification (PCO), and other complications were also assessed.


RESULTS
Of the 84 patients included, 30 had primary angle closure, 28 had pseudoexfoliation, and 26 had diabetic retinopathy. There was no significant difference in the mean opening area between fellow eyes at baseline. In patients with primary angle closure, the area was significantly greater and the percentage reduction in area was significantly less in the capsulotomy group than in the no-capsulotomy group (P≤.0428). In patients with pseudoexfoliation or diabetic retinopathy, the percentage reduction was significantly less in the capsulotomy group than in the no-capsulotomy group (P≤.0493), although there was no significant difference in area. No significant difference was found in IOL decentration or tilt, PCO, or incidence of other complications.


CONCLUSIONS
Neodymium:YAG laser anterior capsule relaxing incisions in the early period after cataract surgery were effective in preventing anterior capsule contraction in high-risk patients and had no adverse effects.


BACKGROUND
No author has a financial or proprietary interest in any material or method mentioned.
Hayashi Eye Hospital, Department of Ophthalmology, School of Medicine, Fukuoka University, Japan. hayashi-ken@hayashi.or.jp
Ken
K
Hayashi
Motoaki
M
Yoshida
Akira
A
Hirata
Hideyuki
H
Hayashi
D000368:Aged; D000369:Aged, 80 and over; D057866:Anterior Capsule of the Lens / Q000601:surgery*; D003286:Contracture / Q000209:etiology / Q000517:prevention & control*; D003930:Diabetic Retinopathy / Q000150:complications; D004311:Double-Blind Method; D017889:Exfoliation Syndrome / Q000150:complications; D005260:Female; D015812:Glaucoma, Angle-Closure / Q000150:complications; D006801:Humans; D053685:Laser Therapy; D053844:Lasers, Solid-State / Q000627:therapeutic use*; D007905:Lens Diseases / Q000209:etiology / Q000517:prevention & control*; D019654:Lens Implantation, Intraocular; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification; D010781:Photography; D011183:Postoperative Complications / Q000517:prevention & control; D012307:Risk Factors