title: Neodymium-yttrium-aluminum-garnet laser lysis of retained cortex after phacoemulsification cataract surgery.
abstract: OBJECTIVE
  To describe the use of the neodymium-yttrium-aluminum-garnet (Nd:YAG) laser to lyse residual cortex after phacoemulsification cataract surgery and report the complications and outcomes of treatment.
  
  
  METHODS
  Interventional, retrospective case series.
  
  
  METHODS
  Consecutive patients who underwent Nd:YAG laser treatment for residual cortex at the Kellogg Eye Center, University of Michigan, Ann Arbor, Michigan were identified by review of laser logs from 2005 to 2011. The medical records were reviewed, and the course and complications of treatment were recorded. The main outcome measures were improvement in subjective vision and corrected distance visual acuity.
  
  
  RESULTS
  Eighteen eyes of 18 patients, mean age 66 ± 11 years, were included. Eight eyes (44%) had intraoperative posterior capsule rupture. Before treatment with the Nd:YAG laser, all patients had subjective visual complaints, with 6 patients reporting counting fingers or worse visual acuity. Eleven patients (61%) were successfully treated with 1 session of cortical lysis, while 5 patients underwent 2 and 2 patients underwent 3 or more treatments. Five patients (28%) had elevated intraocular pressure (IOP) within 1 day of treatment, and 1 patient developed cystoid macular edema. All patients had resolution of subjective visual symptoms, and at final follow-up corrected distance acuity was 20/25 or better in 13 patients (72%).
  
  
  CONCLUSIONS
  The Nd:YAG laser can be used to lyse residual cortex after uncomplicated cataract surgery or cases with intraoperative posterior capsular rupture, and results in an improvement in subjective and corrected distance visual acuity. Elevated IOP is a common complication.
authors.affiliation: Kellogg Eye Center, University of Michigan, Ann Arbor, MI 48105, USA.
authors.forename: Christopher T
authors.initials: CT
authors.lastname: Hood
authors.forename: Roni M
authors.initials: RM
authors.lastname: Shtein
authors.forename: Shahzad I
authors.initials: SI
authors.lastname: Mian
authors.forename: Alan
authors.initials: A
authors.lastname: Sugar
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D053685:Laser Therapy / Q000379:methods*; D053844:Lasers, Solid-State / Q000627:therapeutic use*; D007904:Lens Cortex, Crystalline / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification; D011183:Postoperative Complications; D012086:Reoperation; D012189:Retrospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology