Abstract
Purpose :
To evaluate the long-term outcome of neodymium:yttrium-aluminumgarnet (Nd:YAG) laser posterior capsulotomy after cataract surgery in children.
Methods :
Electronic medical records of pediatric patients who underwent Nd:YAG laser posterior capsulotomy between January 1, 2008, and October 31, 2012, and followed up for more than five years were reviewed. Through evaluating each patient's behavior during slit-lamp examination and anterior segment photography, only compliant patients underwent laser treatment. The mean age at the time of laser treatment and success rate were investigated. LogMAR best-corrected visual acuity (BCVA) before and after treatment was compared and long-term stability of BCVA was evaulated. Complications of laser treatment including the recurrence of posterior capsular opacity were analyzed.
Results :
Thirty one eyes of 25 patients were included. The mean age at the time of initial laser treatment was 9.04 ± 3.51 years (minimum 56 months), and the mean interval between cataract surgery and initial laser treatment was 28.1 ± 22.1 months. Posterior capsular openings were successfully made in 26 (83.9%) eyes with a single attempt and in 3 (9.7%) eyes with second attempt. Overall success rate was 93.5%. The logMAR BCVA was significantly improved from 0.61 ± 0.36 to 0.19 ± 0.25 at 1 month post-treatment (p < 0.0001) and well maintained at least for 5 years of follow-up without serious complications. The recurrence of posterior capsular opacity was observed in 7 (24.1%) eyes, which was successfully managed by repeated laser procedure or surgical capsulectomy.
Conclusions :
By selecting compliant patients and repeated attempts, Nd:YAG laser posterior capsulotomy can be successfully performed in pediatric population without serious complications. Laser treatment is also a good option for managing recurred posterior capsular opacity. Restored visual acuity can be maintained for at least 5 years.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.