A new technique for Nd:YAG laser posterior capsulotomy

AIM:To investigate the effects of a new opening pattern in neodymium:yttrium-aluminum-garnet(Nd:YAG)laser posterior capsulotomy on visual function.METHODS:This technique was conducted along a circular pattern.The energy ranged between 0.8 and1.2 mJ/pulse was consumed and mean total energy levels were 74±21 mJ(mean±standard deviation:SD,from 40 to167)and laser shots aimed at 150μm away behind a datum point and went along an imaginary line which extends 0.5 mm inside from optic margin and into the circular en bloc pattern.Vitreous stands were attached with fragment and then they were cut off by the laser after circular application.The circular fragment was completely separated from vitreous,and then this fragment was quickly sunk in intravitreal space.RESULTS:The follow-up period ranges from at least a week to 40mo,making 15.8mo on average.The procedural outcome showed 96%(74 eyes out of the 77eyes)enhancement in patients’visual acuity.Cystoid macular edema or retinal detachment was not observed in any of the patients during follow-up periods.CONCLUSION:This new technique is expected to improve the weaknesses that the conventional procedures have by adding the process to cut off vitreous stands attached with the fragment by the laser to the circular application.

Early results of circularity and centration of capsulotomy prepared by three different methods

AIM:To compare the difference of capsulotomy produced by precision pulse capsulotomy(PPC),manual(M-CCC),and femtosecond laser assisted capsulotomy(FLAC)in relation to intraocular lens(IOL)centration,circularity and its effect on visual outcomes.METHODS:Prospective,non-randomized comparative study conducted at LV Prasad Eye Institute,Hyderabad,India.Sixty eyes of 52 patients were grouped into 3(FLAC,PPC and M-CCC)based on capsulotomy techniques used.Twenty consecutive eyes with uneventful phacoemulsification and with no comorbidities affecting the capsulotomy or visual outcome were included in each group.The main outcome measure was IOL centration in relation to capsulotomy and pupil.Secondary outcome measures were post-operative visual acuity,manifest refraction and aberration profile between groups.RESULTS:At 5 wk the visual,refractive outcomes and endothelial cell density were comparable between the 3 groups.The median circularity index of FLAC was statistically significantly different to M-CCC or PPC(1-10)groups(P<0.01)but PPC(11-20)was comparable to FLAC.Decentration of IOL center in relation to capsulotomy was seen only between the PPC(1-10)group and FLAC group(P=0.02).The IOL was well centered in relation to the pupil in all the groups(P=0.46).The quality of vision parameters like the higher order aberrations,spherical aberration,coma,trefoil,modular transfer function,and Strehl ratio were comparable between the groups.CONCLUSION:Our study shows that despite differences in the morphology of capsulotomy produced by PPC,M-CCC,FLAC a well-centered IOL can be achieved.The measured capsular morphology parameters do not affect visual outcomes.