title: Effect of Nd:YAG laser capsulotomy on refraction in multifocal apodized diffractive pseudophakia.
abstract: OBJECTIVE
  To evaluate the effect on refraction of neodymium:YAG (Nd:YAG) laser posterior capsulotomy for posterior capsule opacification (PCO), and to evaluate the correlation between automated and subjective refraction in multifocal apodized diffractive pseudophakia.
  
  
  METHODS
  A retrospective study of 75 pseudophakic eyes (50 patients) with multifocal apodized diffractive pseudophakia, treated for PCO with Nd:YAG laser posterior capsulotomy, was performed. Pre- and postintervention values of refractive and visual parameters were compared. The outcomes of autorefraction and subjective refraction were also compared.
  
  
  RESULTS
  Uncorrected and corrected distance visual acuity improved significantly after Nd:YAG capsulotomy (P<.001). No significant changes were noted in defocus equivalent, astigmatic power vectors J(0) and J(45), and overall blurring strength in subjective refraction and autorefraction. Spherical equivalent changed significantly in autorefraction (P=.008), but not in subjective refraction. Autorefraction and subjective refraction were highly correlated in spherical equivalent, defocus equivalent, and blurring strength (r(2)>0.59). In approximately 7% of eyes, a change of more than 0.50 diopters in spherical equivalent in subjective refraction occurred.
  
  
  CONCLUSIONS
  In most cases, Nd:YAG laser capsulotomy in patients with multifocal pseudophakia did not result in a change in refraction. However, 7% of eyes experienced a significant change in subjective refraction. Autorefraction correlated well with subjective refraction in apodized diffractive multifocal IOLs.
authors.affiliation: Department of Ophthalmology, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Violette
authors.initials: V
authors.lastname: Vrijman
authors.forename: Jan Willem
authors.initials: JW
authors.lastname: van der Linden
authors.forename: Carla P
authors.initials: CP
authors.lastname: Nieuwendaal
authors.forename: Ivanka J E
authors.initials: IJ
authors.lastname: van der Meulen
authors.forename: Maarten P
authors.initials: MP
authors.lastname: Mourits
authors.forename: Ruth
authors.initials: R
authors.lastname: Lapid-Gortzak
mesh_terms: D000368:Aged; D058442:Capsule Opacification / Q000601:surgery*; D005260:Female; D006801:Humans; D053685:Laser Therapy; D053844:Lasers, Solid-State / Q000627:therapeutic use*; D019654:Lens Implantation, Intraocular; D008297:Male; D008875:Middle Aged; D057852:Posterior Capsule of the Lens / Q000601:surgery*; D019591:Pseudophakia / Q000503:physiopathology / Q000601:surgery*; D012029:Refraction, Ocular / Q000502:physiology*; D012189:Retrospective Studies; D014792:Visual Acuity / Q000502:physiology