Suprachoroidal haemorrhage following Nd:YAG laser posterior capsulotomy

Nd:YAG laser posterior capsulotomy is the commonest procedure for posterior capsule thickening following cataract surgery. Complications following this laser surgery are relatively few, and this is ordinarily a safe and effective procedure. Herein a case is described of suprachoroidal haemorrhage following Nd:YAG laser posterior capsulotomy. To the best of the authors' knowledge, this is the first report of this complication.Patients undergoing this procedure should be warned of this rare but potentially devastating complication.     

后发性白内障Nd:YAG激光治疗的疗效探讨

目的探讨NdYAG激光治疗后发性白内障的疗效.方法应用NdYAG激光分别对69例白内障超声乳化人工晶体植入术后发障进行后囊膜切开.结果69病例中,后囊膜混浊者共45例(65.2%),后囊膜皱褶者共12例(17.4%),既有后囊膜混浊又有后囊膜皱褶者共12例(17.4%);NdYAG激光后囊膜切开术前后视力有显著性差异(P〈0.005),69例中有60例经过NdYAG激光后囊膜切开术后视力达到了白内障超声乳化术后的最佳视力;但仍有9例未达到该最佳视力.结论"囊袋收缩综合征"影响NdYAG激光后囊膜切开术的治疗效果,白内障手术方法和人工晶体的选择可降低后发障的发生.     

后囊膜混浊的Nd:YAG激光治疗

目的：探讨Nd:YAG激光后囊膜切开的方法，疗效及并发症。方法：回顾性分析了108例112只眼用Nd:YAG激光切开混浊后囊膜的病例，并记录了视力，眼压的变化和并发症的发生情况，结果；所有病例都成功切开后囊膜，视力提高，裸眼平均视力由术前0.2增加到术后0.5，平均矫正视力达到0.7,30.3%的眼内人工晶状体出现激光损伤斑，无人工晶状体移位；眼压出现一过性升高；随访中发现2例视网膜脱离，结论：Nd:YAG激光后囊膜切开操作容易，安全，疗效好，并发症少。     

Nd：YAG激光治疗后发膜性白内障术后眼压升高的探讨

本文探讨９５人１０４只眼Ｎｄ：ＹＡＧ激光治疗后发膜性白内障术后眼压升高的原因。以激光前后眼压升高差值≥５ｍｍＨｇ为标准，眼压差值≥５ｍｍＨｇ组与＜５ｍｍＨｇ组两组总能量分别是６１５．４１±１１２９．８０ｍＪ和２０３．７１±３４２．６６ｍＪ，经统计学处理有显著差异。我们将术前眼压分为≥２０ｍｍＨｇ组与＜２０ｍｍＨｇ两组，术前眼压≥２０ｍｍＨｇ组术后眼压升高≥５ｍｍＨｇ占７３％，术前眼压＜２０ｍｍＨｇ组术后眼压升高≥５ｍｍＨｇ的占４４％，两组比较有差异。结论：①术中能量的大小是术后眼压升高的主要因素，击射时总能量大，术后眼压升高明显。②术前眼压高低也可影响术后眼压。提示我们在击射时选择适当的能量，降低术前眼压，控制术后炎症则可有效地减少术后眼压升高的发生     

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 and 1.2 mJ/pulse was consumed and mean total energy levels were 74±21 mJ (mean±standard deviation:SD, from 40 to 167) and laser shots aimed at 150 µm 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 77 eyes) 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.     

Intraocular pressure elevation following Nd:YAG laser posterior capsulotomy

Intraocular pressures (IOP) and tonographic outflow facilities were measured following neodymium (Nd): YAG laser posterior capsulotomy in 13 pseudophakic and 8 aphakic eyes. Mean intraocular pressure (IOP) peaked by three hours with a mean increase of 13 mmHg, remained elevated by 5 mmHg at 24 hours but returned to baseline by one week. Fourteen eyes (67%) had greater than or equal to 10 mmHg elevation and eight (38%) had greater than or equal to 40 mmHg maximum IOP. All the patients who eventually demonstrated a greater than or equal to 10 mmHg elevation within six hours of the capsulotomy initially had an IOP elevation greater than or equal to 5 mmHg at one hour. The mean outflow facility was reduced from 0.18 microl/min/mmHg before capsulotomy to 0.08 microl/min/mmHg (55%, P less than 0.0001) at four hours and was still decreased at 0.13 microl/min/mmHg (27%, P less than 0.05) at one week. Seventy-five percent of aphakic and 15% of pseudophakic patients had maximum IOP greater than or equal to 40 mmHg (P less than 0.01). Measurements should be performed one hour postlaser in all patients for IOP and three to four hours in aphakic patients, glaucomatous patients, patients receiving greater than or equal to 200 mjoules total laser energy, and patients with greater than or equal to 5 mmHg elevation at one hour in order to detect and treat significant IOP elevations.     

Malignant glaucoma as a complication of Nd:YAG laser posterior capsulotomy.

A 79-year-old woman with pseudophakia who underwent Nd:YAG posterior capsulotomy for posterior capsular opacification in her right eye had increased intraocular pressure associated with a flat anterior chamber. Full-thickness patent iridotomy performed with an Nd:YAG laser did not reduce the intraocular pressure. B-scan ultrasonography showed aqueous pockets in the vitreous, leading to a diagnosis of malignant glaucoma. Medical and surgical therapy normalized the intraocular pressure and resolved the symptoms of malignant glaucoma.     

从视野角度来探讨4mm直径Nd:YAG激光后囊膜切开术

目的 :从视野角度来探讨 4mm直径后囊膜切开的适用性。方法 :2 0例后囊膜Ⅱ级混浊患者行Nd :YAG激光4mm直径后囊膜切开术 ,术后 1个半月计算机静态视野检查 ,与行同样白内障术后后囊膜透明组 2 1例检查视野进行比较。结果 :4mm后囊膜组中心 30°及周边 6 0°视野结果 (均数±标准差 ) ,MD(- 4 0 8± 2 73)、PSD(3 0 5± 2 13)、周边 6 0°总光敏感度 (94 5 95± 2 4 4 74 )dB、后囊膜透明组 :MD(- 2 93± 3 10 )、PSD(2 38± 1 4 6 )、周边 6 0°总光敏感度 (992 0 0± 2 5 6 0 5 )dB。经单因素方差分析两组的MD、PSD及周边 6 0°总光敏感度比较 ,差异无显著性意义 (P >0 0 5 )。结论 :4mm切开孔从视野角度来说是个可选用的后囊膜切开直径。     

Long-term results of Nd:YAG laser posterior capsulotomy with the Swiss laser

The Microruptor II (MR-II) Nd:YAG laser developed by Fankhauser was evaluated in a national multicenter prospective study of posterior capsulotomy. Results are reported on 3,711 patients who underwent Nd:YAG laser photodiscission. Ninety-two percent of patients experienced an improvement in vision at some point following photodiscission and the postoperative complications of persistent cystoid macular edema and glaucoma occurred at rates of 2.5% and 0.2%, respectively, indicating the safety and efficacy of the MR-II for posterior capsulotomy.     

Use of Nd:YAG laser capsulotomy

Surgery for cataract removal has become successively refined such that posterior capsular opacification is the most common problem presenting after modern cataract extraction. Various techniques and treatments exist to manage patients with posterior capsular opacification using Nd:YAG capsulotomy. There are many possible variations in initial assessment, pre-laser treatments, laser techniques, and follow-up routines. The literature on the use of Nd:YAG laser for capsulotomy was reviewed and interpreted. This article presents the currently available knowledge in a format that allows the practitioner to tailor an evidence-based protocol for treating patients with symptomatic posterior capsule opacification.     

Nd:YAG激光在散大瞳孔后对IOL术后PCO治疗的体会

目的:探讨Nd:YAG激光在散大瞳孔后治疗人工晶状体(IOL)植入术后后发性白内障的方法和效果。方法:应用Nd:YAG激光机对500例后发性白内障行激光后囊切开术。结果:切开术成功率为99.8%,视力增进者97.2%。结论:Nd:YAG激光于散大瞳孔后治疗后发性白内障IOL损伤小、视力提高显著。     

"String of pearls" following Nd:YAG laser posterior capsulotomy

Posterior capsular re-opacification can occur following Nd-YAG capsulotomy. This necessitates multiple capsulotomies with its potential complications. We report one such case and discuss possible predisposing factors and preventive measures for this condition.     

Acute elevations of intraocular pressure following Nd:YAG laser posterior capsulotomy

We performed applanation tonometry preoperatively, hourly for the first four postoperative hours and on the first postoperative day in 66 eyes after Nd:YAG laser posterior capsulotomy in order to determine the nature of the acute intraocular pressure (IOP) elevation and the risk factors involved. Forty-one percent of eyes developed an intraocular pressure greater than 30 mmHg and 14% greater than 40 mmHg. The IOP spike occurred on the second postoperative hour in 35% of eyes. Patients with controlled glaucoma prior to capsulotomy had a significantly lower mean IOP rise than patients without glaucoma. Eyes with posterior chamber IOLs were less likely to develop an IOP greater than 30 mmHg than were aphakic eyes without IOLs. There was no correlation between the laser energy or the size of the capsulotomy and the IOP rise.