后发性白内障形态及对视功能影响临床分析

目的 通过对后发性白内障(Posterior Capsule Opacification,PCO)的形态学及其对视功能影响的客观综合评价,为临床激光后囊切开术提供指导意义.方法 选择61例(67只眼)后发性白内障拟行Nd:YAG 激光后囊切开术的患者,充分散大瞳孔(直径>6.00mm),先采用裂隙灯加前置镜行主观评价,再行裂隙灯眼底后部反光裂隙照相,所得数码图像使用POCOman软件进行分析,得出PCO的POCOman半客观评分.于Nd:YAG激光后囊切开术前、术后分别测量其最佳矫正视力(best corrected visual acuity,BCVA),同时使用自动眩光对比敏感度检查仪进行对比敏感度(contrast sensitivity,CS)和眩光对比敏感度(glare sensitivity,GS)的检测.分析统计不同类型、不同部位、不同程度PCO与视功能的关系.结果 珍珠型PCO在中心视力、各频段对比敏感度和眩光敏感度均低于纤维型PCO,且两者之间的差异有统计学意义(P<0.05);中央4.0mm珍珠型PCO在低、中频段对比敏感度和中频段眩光敏感度均低于中央2.0mm珍珠型PCO,差异有统计学意义(P<0.05).中央2.0mm纤维型PCO在中、高频段对比敏感度和低、中频眩光敏感度均低于中央4.0mm纤维型PCO,差异有统计学意义(P<0.05).中央2.0mm珍珠型PCO对最佳矫正视力的影响最为显著;中央4.0mm珍珠型PCO对对比敏感度和眩光敏感度的影响最为显著.随着PCO程度的增加,中心视力、全频段对比敏感度和全频段眩光敏感度逐渐下降.其间的差异有统计学意义.POCOman评分与最佳矫正视力、各频段对比敏感度、低中频段眩光敏感度的变化呈正相关(P<0.05),差异有统计学意义.结论 对后发性白内障行形态学及其对视功能受损的客观综合评价,可成为判断Nd:YAG激光晶状体后囊膜切开术手术时机和评价手术疗效的方法.     

人工晶状体眼晶状体后囊膜混浊对视功能的影响

目的:探讨人工晶状体眼晶状体后囊膜混浊对患者最佳矫正视力、对比敏感度、立体视觉及色觉等诸项视功能的影响。方法:对30例患者(35眼)超声乳化白内障摘除人工晶状体植入术后,发生后囊膜混浊(posteriorcapsuleopacification,PCO)的患眼及对侧眼进行最佳矫正视力、对比敏感度、立体视觉及色觉等项检查。对患眼施行Nd:YAG激光晶状体后囊膜切开术。术后1wk重复上述视功能检查,将术前术后检查结果进行配对比较分析,单眼患者与对侧眼进行比较。结果:Nd:YAG激光晶状体后囊膜切开术前患眼的LogMAR视力平均(0.43±0.33),术后LogMAR视力平均(0.08±0.12),术后视力较术前提高差异有极显著性(P<0.05)。患眼各空间频率的对比敏感度较术前均有明显提高,差异有统计学极显著性(P<0.01);而对侧眼术前最佳矫正视力、各空间频率对比敏感度与术后复查结果比较差异无显著性(P>0.05)。采用颜少明《立体视觉检查图》检测显示,激光后囊膜切开术前立体视觉阳性13例(43%),其中2例(7%)具有中心立体视,无立体视者17例(57%);Titmus立体视觉检查卡检查显示22例患者(73%)立体视阳性,其中4例有中心立体视(13%),无立体视功能者8例(27%)。术后颜氏《立体视觉检查图》和Titmus立体视觉检查卡检测的立体视阳性分别为24例(80%)和28例(93%),其中分别有11例(37%)和15例(50%)达到中心立体视,术后的立体视觉较术前改善差异有显著性(P<0.05)。术前全部患眼存在色觉异常,主要表现在蓝紫色及绿色辨别能力下降,术后色觉障碍有一定程度提高,但蓝紫色觉改善不明显。结论:人工晶状体植入术后后囊膜混浊不仅影响患眼视力的康复,还对对比敏感度、立体视锐度、色觉等多种视功能有不同程度的影响。Nd:YAG激光晶状体后囊膜切开术是治疗PCO,提高视力和改善视功能的有效方法。     

人工晶状体后囊膜混浊激光治疗前后视功能的变化

目的探讨人工晶状体植入术后后囊膜混浊(PCO)对视功能的影响以及Nd:YAG激光治疗后的变化。设计前瞻性自身对照研究。研究对象接受超声乳化白内障摘除人工晶状体植入术57例(59眼)PCO患者。方法对57例(59眼) PCO患者行Nd:YAG激光治疗。于治疗前、后对患眼和对侧眼进行LogMAR视力、最佳矫正视力、对比敏感度、近距立体视锐度检查。主要指标 LogMAR视力、最佳矫正视力、对比敏感度、立体视锐度。结果激光治疗前患眼的平均LogMAR视力(0．22)及患眼各频区的对比敏感度值均较对侧眼显著低下;治疗后有明显提高(LogMAR视力0．00)。治疗后立体视阳性比率和达到中心立体视的比率,以及平均立体视锐度值均较治疗前有显著性改善。治疗后立体视锐度仍未达到正常者与最佳矫正视力低常、屈光参差及原有眼病有关。结论 PCO不仅影响患眼视力和对比敏感度,也影响立体视功能。Nd:YAG激光后囊膜切开术是治疗 PCO、恢复患者视力和重建正常立体视功能的有效手段。     

白内障超声乳化人工晶状体植入术后对比敏感度与眩光对比敏感度变化分析

目的 分析白内障超声乳化人工晶状体植入术后对比敏感度与眩光对比敏感度变化.方法 选取我院2009年1月至2010年6月行超声乳化人工晶状体植入术的白内障患者45例(60眼),术后随访1～6个月,平均3.5个月.观察患者术前及术后随访末期BCVA,并于术前及术后1个月检测患者对比敏感度和眩光对比敏感度.结果 患者术后BCVA较术前显著提高,差异有统计学意义(P＜0.05).明视无眩光及明视眩光条件下,患者术后各空间频率下的对比敏感度及眩光对比敏感度较术前均明显提高,差异均有显著统计学意义(均为P＜0.01).暗视无眩光及暗视眩光条件下,除高空间频率(18.0c·d-1)外,患者术后其他空间频率下的对比敏感度及眩光对比敏感度较术前均明显提高,差异均有显著统计学意义(均为P ＜0.01).明视及暗视条件下,眩光对于患者术前、术后高空间频率(12.0 c·d-1、18.0c·d-1)下的对比敏感度均无明显影响(P＞0.05),但对术前、术后其他空间频率下的对比敏感度均有明显影响(P＜0.01).与暗视眩光条件相比,明视眩光条件下的患者术前、术后各空间频率对眩光比敏感度均较高,差异均有统计学意义(均为P ＜0.05).结论 对比敏感度及眩光对比敏感度检查可以作为白内障患者更客观有效的视功能检查方法.     

减少Nd:YAG激光后囊膜切开术人工晶状体损伤的探讨

目的　探讨减少或避免 Nd:YAG激光后囊膜切开术人工晶状体 (IOL )损伤的方法。方法　对 2 5 2例(2 6 1只眼 ) IOL眼晶状体后囊膜混浊 (posterior capsule opacity,PCO)患者行 Nd:YAG激光后囊膜切开术。采用环行切开后推膜瓣法或十字形切开法。平均单脉冲能量 (2 .35± 0 .38) m J,平均脉冲次数 (2 9± 10 .2 1)次 ,平均总能量(6 8.15± 11.0 2 ) m J。平均随访 (13± 5 )个月。结果　截囊成功率 10 0 %。发生 IOL损伤 12只眼 (4 .6 % ) ,均为轻度损伤。 1、2级 PCO和较薄的 PCO未发生 IOL损伤。结论　掌握激光手术时机及操作技巧是减少或避免 Nd:YAG激光后囊膜切开术 IOL损伤的关键     

微切口超声乳化加非球面人工晶状体植入治疗白内障的临床评价

目的:探讨超声乳化联合非球面人工晶状体植入对白内障患者术后视觉质量的影响.方法:年龄相关性白内障患者(50例63眼)随机分为试验组25例33眼和对照组25例30眼,两组患者手术方法相同,试验组植入非球面人工晶状体,对照组植入球面人工晶状体;比较术后裸眼视力、最佳矫正视力,并检查两组患者对比敏感度和像差.结果:术后1wk;1,3mo两组患者裸眼视力相比差异无统计学意义(P＞0.05),术后3mo两组最佳矫正视力相比差异亦无统计学意义(P＞0.05).在非眩光和眩光条件下,两组患者在3.0,6.0,12.0,18.Ocd频段下对比敏感度比较差异无统计学意义(P＞0.05);在1.5cd频段下,试验组对比敏感度值显著高于对照组,组间比较差异具有统计学意义(P＜0.05);术后3 mo试验组球差、彗差均显著低于对照组,两组间比较差异具有统计学意义(P＜0.05).结论:非球面人工晶状体在低频段对比敏感度显著优于球面人工晶状体,并能够降低白内障患者术后的总像差,从而提高白内障患者术后的视觉功能.     

Aurium变色人工晶状体植入术后对比敏感度和眩光对比敏感度的研究

目的 研究Aurium变色人工晶状体对术后对比敏感度和眩光对比敏感度的影响.方法 临床病例系列对比研究.选取2010年8月至2011年4月在南昌大学第二附属医院眼科就诊的白内障超声乳化联合人工晶状体植入术后患者,且随访资料完整的病例70例(眼),其中37例为Aurium (model400)变色人工晶状体组,33例为黄色蓝光滤过型IQ (SN60WF)人工晶状体组.观察患者术后3个月时的裸眼视力(UCVA),最佳矫正视力(BCVA),对比敏感度(CS)和眩光对比敏感度(GS).结果 二组患者术后3个月时的裸眼视力和最佳矫正视力差异均无统计学意义(P＞0.05).Aurium组和IQ组在明适应、明适应眩光、暗适应条件下,两组之间的对比敏感度和眩光对比敏感度差异无统计学意义(P＞0.05),在暗适应眩光条件下Aurium组的眩光对比敏感度(空间频率3 cpd、6 cpd)要优于黄色蓝光滤过型IQ组,差异有统计学意义(P＜0.05).结论 植入Aurium变色人工晶状体术后患者的视力与黄色蓝光滤过型IQ人工晶状体的视力差异无统计学意义.Aurium变色人工晶状体在暗适应眩光条件下,空间频率(3 cpd、6 cpd)的眩光对比敏感度要优于黄色蓝光滤过型IQ人工晶状体.     

白内障术后晶状体后囊膜混浊及远期视力下降影响因素分析

目的探讨白内障术后晶状体后囊膜混浊(posterior capsular opacification,PCO)发生及术后远期视力下降的影响因素。方法收集行白内障超声乳化摘出联合人工晶状体植入术的年龄相关性白内障患者37例(47眼),记录患者术前、术后的眼部检查情况及是否行后囊膜抛光处理等术中情况,于术后2a对PCO进行分级评价。结果 47眼中,有25眼在术后2a发生了PCO,其中18眼混浊已累及中心3mm区,4眼已行YAG激光后囊膜切开术,后囊膜切开率8.5%。统计分析显示,PCO和混浊累及中心3mm区的发生率在是否行后囊膜抛光眼之间的差异均有统计学意义(均为P<0.05)。在各因素中,行后囊膜抛光是发生PCO以及混浊累及中心3mm区仅有的保护性因素。累及中心3mm区的PCO、眼底疾病和黄斑病变与术后2a视力变化之间的关联均有统计学意义(均为P<0.05)。结论白内障术后发生累及中心3mm区的PCO可导致术后远期视力下降;术中行后囊膜抛光处理可显著降低PCO的发生率和严重程度。     

不同边缘形状的人工晶状体与后发性白内障的临床研究

目的　观察直角边缘和弧形边缘折叠式人工晶状体植入术的临床效果 ,探讨手术因素 ,以及人工晶状体材料和边缘形状等因素对后发性白内障发生的影响。方法　观察 14 0例 (14 0只眼 )白内障患者超声乳化白内障吸除囊袋内折叠式人工晶状体植入术后的视力、晶状体囊袋和人工晶状体情况。直角边缘组 90只眼 ,术中植入疏水性丙烯酸酯直角边缘人工晶状体 ,随访时间 (14± 8)个月 ;弧形边缘组 5 0只眼 ,术中植入非疏水性丙烯酸酯弧形边缘人工晶状体 ,随访时间 (18± 8)个月。结果　晶状体后囊膜混浊直角边缘组 8只眼 (8 9% ) ,弧形边缘组 19只眼 (38 0 % ) ,两组比较差异有非常显著意义 (P <0 0 1)。环形撕囊口大小适中直角边缘组 76只眼 ,无晶状体后囊膜混浊发生 ;弧形边缘组 4 1只眼 ,其中 10只眼 (2 4 4 % )出现晶状体后囊膜混浊 ,两组比较差异有非常显著意义 (P<0 0 1)。环形撕囊口过大或偏位直角边缘组 14只眼 ,其中晶状体后囊膜混浊 8只眼 (5 7 1% ) ;弧形边缘组 9只眼 ,全部发生晶状体后囊膜混浊 (10 0 0 % ) ,两组比较差异有显著意义 (P <0 0 5 )。行激光晶状体后囊膜切开术直角边缘组 1只眼 (1 1% ) ,弧形边缘组 5只眼 (10 0 % ) ,两组比较差异有显著意义(P <0 0 5 )。结论　手术操作、人工晶状     

Acrysof与Natural人工晶状体植入的疗效比较

目的 对比Acrysof与Natural这两种不同人工晶状体植入后的效果。方法 随机各挑选35例老年性白内障行Phaco+Acrysof人工晶状体和Phaco+Natural的患者,用调查表的方式,记录术前,术后1天、1周、1月的的裸眼视力、眼压;并记录术后1周时的眩光、物体颜色、不同光线、不同环境中的视力和活动能力、心情等项目。并收集2003年一眼植入Acryseof,2004年另一眼植入Natural的患者10例,对比Acrysof植入1年与Natural植入1周后的感觉对比。结果 术前平均视力4±0.69,Acryosf(SA60AT)和Acrysof Natural(SN60AT)的术后1周平均视力、眩光、视物颜色平均得分分别是4.79±0.17,4.80±0.21;2.37±0.77,3.49±0.82;2.97±0.30,3.64±0.65。两组术后1周视力差异P＞0.05,差别无统计学意义。眩光和视物颜色P＜0.01,差别有非常显著性差异。其他项目平均分数均在3～4之间,两组间P＞0.05差别无统计学差异。结论Acrysof与Natural单片式人工晶状体植入后裸眼视力差异无显著性。但Natural植入后患者的眩光与蓝色视明显较Acrysof轻。Acrysof植入1年与Natural植入1周,各种指标元明显差异。     

Correlation between posterior capsule opacification and visual function before and after Neodymium: YAG laser posterior capsulotomy

PURPOSE: To investigate the correlation between visual acuity, contrast sensitivity, and contrast sensitivity with glare source (glare sensitivity), and the degree of posterior capsule opacification (PCO) before and after neodymium:yttrium-aluminum-garnet (Nd:YAG) laser posterior capsulotomy. DESIGN: Prospective interventional case series. METHODS: Eighty-four patients (90 pseudophakic eyes) scheduled to undergo Nd:YAG laser capsulotomy were recruited. Visual acuity and contrast sensitivity with and without the presence of a circular glare source (using the contrast glare tester) were measured before and after Nd:YAG laser capsulotomy. The PCO density value was measured using a Scheimpflug videophotography system. The visual functions were statistically correlated with the PCO value. RESULTS: Before Nd:YAG laser capsulotomy, strong correlation existed between the PCO value and visual acuity (r = 0.728). Contrast sensitivity and glare sensitivity were also weakly correlated with the PCO value, but the correlation coefficients were smaller than that of visual acuity. After Nd:YAG laser capsulotomy, mean visual acuity, contrast sensitivity, and glare sensitivity at all visual angles improved significantly (P <.0001). After capsulotomy, no significant correlation was found between visual acuity, contrast sensitivity, or glare sensitivity and the PCO value. CONCLUSIONS: Before Nd:YAG laser capsulotomy, visual functions correlated significantly with the degree of PCO. Specifically, visual acuity has a stronger association with PCO than does contrast sensitivity or glare sensitivity and therefore should be considered to reflect most accurately the degree of PCO. After capsulotomy, these visual functions improve markedly and no longer have a significant correlation with PCO.     

Comparison of posterior capsule opacification between fellow eyes with two types of acrylic intraocular lens

PURPOSE: To compare the degree of posterior capsule opacification (PCO) and visual function between fellow eyes that received two different types of hydrophobic acrylic intraocular lenses (IOLs). METHODS: Forty-five patients underwent bilateral phacoemulsification and implantation of an Alcon AcrySof IOL (MA60AC) in one eye and an AMO Sensar IOL (AR40e) in the fellow eye. The PCO density value was measured using the Scheimpflug videophotography system at 1, 6, 12, and 24 months after surgery. The incidence of eyes that required a neodymium:YAG (Nd:YAG) laser capsulotomy, visual acuity, and contrast sensitivity with and without a glare source were also examined. RESULTS: The mean PCO value did not show a significant increase in either the AcrySof MA60AC or Sensar AR40e IOL groups, and was similar between the two groups throughout the 24-month follow-up period. The incidence of Nd:YAG laser capsulotomy was also the same between the groups. No significant difference was found in mean visual acuity between the two IOL groups during the follow-up, and there was no significant difference in photopic or mesopic contrast visual acuity with and without a glare source at 1 and 24 months after surgery. Conclusion: The degree of PCO in eyes with an AcrySof IOL are almost the same as that in eyes with a Sensar IOL, with the results that visual acuity and contrast sensitivity with and without glare are similar.     

Q开关Nd:YAG激光治疗后囊膜混浊

目的:探讨Q开关Nd:YAG激光后囊膜切开术治疗后囊膜混浊的疗效及安全性。方法:回顾性分析行Q开关Nd:YAG激光后囊膜切开术后囊膜混浊患者165例(193眼),记录手术前后视力、眼压及并发症,并进行统计学分析。结果:①后囊膜一次性切开成功率为100%,所用激光脉冲数平均24±21.7次,激光总能量4~451mJ;②91.2%(176眼)视力较术前提高;③59.6%(115眼)出现一过性眼压升高;手术前后眼压变化与是否植入人工晶状体、所用激光脉冲数以及白内障手术与后囊膜切开术间隔时间有关;④19.3%(32眼)出现人工晶状体损伤。结论:Q开关Nd:YAG激光后囊膜切开术治疗后囊膜混浊安全、有效,但应严格掌握适应证,并合理选择激光参数。     

钇铝石榴石激光治疗白内障摘除术后并发症的临床研究

目的探讨白内障摘除术后钇铝石榴石(yttriumaluminumgarnet,YAG)激光的应用范围,激光后囊膜切除术的方法、疗效和并发症.方法超声乳化白内障吸除人工晶状体(intraocularlens,IOL)植入手术4600只眼,术后YAG激光治疗451只眼,其中行后囊膜切除380只眼,切除方法采用连续环状切开及后推膜瓣二步法;连续环状切开时平均单脉冲能量为(1.21±0.31)mJ,平均总能量为(52.44±14.62)mJ;后推膜瓣时平均单脉冲能量为(2.12±0.43)mJ,平均总能量为(50.88±10.32)mJ.IOL前膜切除42只眼,脉冲能量为1.0～1.4mJ,平均总能量为(56.28±32.74)mJ.治疗其他术后并发症29只眼.结果白内障摘除术后行YAG激光治疗451只眼(9.8%).后囊膜切除手术率为8.3%;1次激光手术成功率为96.3%;平均裸眼视力提高0.26,矫正视力为0.85;未出现明显的IOL损伤和移位;362只眼(95.3%)眼压正常;2只眼视网膜脱离.结论YAG激光无需切口可在眼内完成精确的分割手术,且操作方便、安全,疗效好、并发症少、应用范围广.     

Effect of primary posterior continuous curvilinear capsulorhexis on clinical performance of ACR6D SE single-piece hydrophilic acrylic intraocular lenses

PURPOSE: To evaluate the effects of a primary posterior continuous curvilinear capsulorhexis (PCCC) on the clinical performance of a single-piece hydrophilic acrylic intraocular lens (IOL) with haptic angulation. SETTING: Department of Ophthalmology, Medical University of Vienna, Vienna, Austria. METHODS: A prospective study of 52 patients with bilateral age-related cataract was conducted. Patients had standard cataract surgery with implantation of the same IOL in both eyes. Randomly, a PCCC was created in 1 eye and the posterior capsule was left intact in the fellow eye. Assessed parameters were visual axis opacification (VAO) in eyes with a PCCC or regeneratory posterior capsule opacification (PCO) in eyes without PCCC (scale 0 to 10) in the central (3.0 mm eccentricity), intermediate (3.0 to 4.5 mm eccentricity), and peripheral (>4.5 mm eccentricity [capsulorhexis edge]) areas; neodymium:YAG (Nd:YAG) laser capsulotomy or laser polishing of ongrowing lens epithelium; anterior capsule opacification (ACO); best corrected visual acuity (BCVA); and contrast sensitivity. RESULTS: Thirty patients completed the 2(1/2)-year follow-up. Visual axis opacification was significantly lower in the central region in the PCCC group (mean 0.5 +/- 0.7 [SD]) than PCO in the central region of the non-PCCC group (mean 1.1 +/- 1.1) (P = .02). Forty percent in the non-PCCC group had an Nd:YAG laser capsulotomy during the follow-up period; none in the PCCC group had laser polishing. There were no significant differences in ACO, SE, BCVA, or contrast sensitivity. There was no additional gain in BCVA or contrast sensitivity in eyes with a PCCC compared with eyes without a PCCC when VAO and PCO were low. CONCLUSION: A PCCC significantly reduced PCO formation within the central 3.0 mm eccentricity as well as the need for Nd:YAG laser capsulotomy in eyes with a single-piece hydrophilic acrylic IOL with angulated haptics.     

Influence on posterior capsule opacification and visual function of intraocular lens optic material

PURPOSE: To examine the influence of optic material on posterior capsule opacification (PCO) by comparing PCO and visual functions between eyes with an acrylic intraocular lens (IOLs) and those with a silicone IOL of the same optic design and with the same haptics. DESIGN: Randomized clinical trial. METHODS: One hundred patients scheduled for phacoemulsification surgery underwent implantation of an acrylic IOL (AMO Sensar; AR40e) in one eye and implantation of a silicone IOL (ClariFlex) of the same optic design and loops in the fellow eye. Eighty-nine patients (89%) remained for analysis. The PCO value was measured using the Scheimpflug videophotography system at one, three, six, 12, 18, 24, 30, and 36 months postoperatively. The incidence of eyes that required a neodymium:yttrium-aluminum-garnet (Nd:YAG) laser capsulotomy was examined; visual acuity and contrast sensitivity with and without a glare source were also evaluated. RESULTS: The mean PCO value did not increase significantly during follow-up in either the acrylic or silicone IOL group. When comparing the groups, no statistically significant difference was found in the PCO or in the incidence of Nd:YAG capsulotomy, although both tended to be slightly better in the silicone group than in the acrylic group. There was also no significant difference between the groups in visual acuity or in photopic and mesopic contrast sensitivity with or without glare. CONCLUSIONS: When acrylic and silicone IOLs are of the same optic design and with the same haptics, the optic material does not influence the development of PCO enough to impair visual function.     

Hydrophobic Acrylic Intraocular Lens in Both Eyes

 PURPOSE: To report on the clinical findings of a case of late opacification of the hydrophobic acrylic intraocular lens (IOLs) in both eyes after cataract surgery. METHODS: A 79-year-old man with a history of decreased visual acuity and complaints of glare and blurred vision in both eyes over the past 3 years. He had received an uneventful phacoemulsification combined with posterior chamber IOL implantation for senile cataract in both eyes 13 years ago, and had undergone neodymium:YAG(Nd:YAG) laser posterior capsulotomy on both eyes 6 years ago, for posterior capsular opacification (PCO). The optical portion of the IOLs showed uniform gray haze. Binocular posterior capsular laser holes were clearly noted. RESULTS: IOL exchange was performed by the same surgeon on both eyes, three days apart. Postoperatively, the patient's visual acuity was elevated to 6/12 (OD) and 6/9 (OS) at 6 months, and intraocular pressure (IOP) reached 16.8 mmHg (OD) and 18.4 mmHg (OS). Neither glare or blurred vision were observed in either eye. CONCLUSION: IOL exchange can be used to effectively manage clinically significant optic opacification.       

Outcome of posterior capsulotomy in late capsular block syndrome with posterior capsular opacification

BACKGROUND: To examine the results of neodymium:yttrium-aluminium-garnet (Nd:YAG) laser posterior capsulotomy in eyes with late or previously unrecognized capsular block syndrome (CBS) presenting with deterioration of vision owing to posterior capsular opacification (PCO). METHODS: Patients, who underwent uneventful phacoemulsification with intraocular implantation and were referred for Nd:YAG laser capsulotomy owing to PCO, were prospectively examined for the presence of CBS. When indicated, Nd:YAG laser posterior capsulotomy was carried out. Prospective follow-up examinations were performed for the next 6 months. The outcome measures were post-laser change in best corrected visual acuity, refraction, change in intraocular pressure, inflammation and complication rate. RESULTS: Of 655 patients referred for capsulotomy, eight had an associated CBS in that eye. These eight eyes comprised the study cases. The presence of CBS had not been recognized before the development of PCO. Best corrected visual acuity improved in all cases. In seven out of eight (87.5%) eyes refraction was unchanged throughout the follow up. Ocular hypertension, inflammation or other complications did not develop. CONCLUSION: Nd:YAG laser capsulotomy in eyes with PCO and late or previously unrecognized CBS is a safe procedure, resulting in improved visual acuity without refractive change.     

Neodymium: YAG laser capsulotomy with a biconvex intraocular lens

There are optical and mechanical advantages of the biconvex posterior chamber intraocular lens (IOL) following cataract surgery. A clinical study of Nd:YAG laser capsulotomy in eyes with biconvex IOLs was undertaken. The lenses were made of injection-molded poly(methyl methacrylate) without laser spacing. Using specified techniques, YAG laser capsulotomy was performed in 19% of 436 eyes without significant damage to the IOL and without affecting visual acuity or glare disability.