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Hemalatha Kolli, Charlotte Evers, Philip Ian Murray; Nd:YAG laser posterior capsulotomy in patients with uveitis. Invest. Ophthalmol. Vis. Sci. 2020;61(7):2073.
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Nd:YAG laser posterior capsulotomy is a safe and effective treatment for posterior capsule opacification (PCO), although serious post-laser complications have been described. Cataract surgery can be challenging in the uveitic eye and a higher incidence of PCO and laser posterior capsulotomy is well documented. Little is known about the safety profile of laser treatment in these eyes as they may be more at risk of developing post-laser complications. We studied the complication rate of Nd:YAG laser posterior capsulotomy in patients with uveitis.
Retrospective case note analysis of pseudophakic uveitis patients having undergone Nd:YAG laser posterior capsulotomy between January 2016 and December 2018. Complications documented were laser induced flare of uveitis (a 2-step increase in anterior chamber cells and/or 2-step increase in vitreous haze), raised intraocular pressure >25 mmHg or worsening of pre-existing glaucoma, intraocular lens pitting/decentration/subluxation/dislocation, development or exacerbation of cystoid macular oedema and retinal detachment.
There were 39 eyes of 38 patients (20M, 18F; age 27-89 years) with various anatomical types of uveitis (anterior 17, intermediate 6, pan 11, posterior 4). Phakoemulsification had been performed in 38 eyes (2 combined with a vitrectomy) and the commonest lens material implanted was hydrophilic acrylic. Mean interval between cataract surgery and laser was 55 months (range 8-286 months). Mean laser energy was 79 mJ (range 33-207 mJ). All patients were followed up for a minimum of 12 months. Post-laser visual acuity was available in 34 eyes. At 3 months 26/34 eyes had an improvement in vision with 21/26 eyes improving by 2-5 Snellen lines, and visual acuity was maintained over the 12-month follow-up. Post-laser acuity was unchanged in 8 eyes, mainly due to pre-existing macular pathology. No eyes had a worsening of vision. Two eyes required re-treatment. No post-laser complications were documented over the follow-up period.
Nd:YAG laser posterior capsulotomy is a safe procedure in uveitic eyes, resulting in a good improvement in vision unless there are pre-existing pathologies.
This is a 2020 ARVO Annual Meeting abstract.
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