Impact of Neodymium-Doped Yttrium Aluminum Garnet (ND-YAG) Posterior Capsulotomy Laser Treatment on Central Macular Thickness: A Prospective, Observational Study From a Tertiary Care Center

Cureus. 2021 Jul 7;13(7):e16242. doi: 10.7759/cureus.16242. eCollection 2021 Jul.

Abstract

Introduction Opacification of the posterior capsule is labeled as a secondary cataract. The objective of the current study was to assess central macular thickness (CMT) changes following neodymium-doped yttrium aluminum garnet (ND-YAG) posterior capsulotomy and to find out the correlation between CMT with the age, energy, and total shots utilized during the procedure. Methodology In this single-centered prospective observational study, 137 patients with a mean age of 57 ± 12.61 years, who had cataract surgery previously and were candidates for ND-YAG posterior capsulotomy were recruited through consecutive sampling. The study was conducted at Layton Rahmatulla Benevolent Trust (LRBT) Free Eye Hospital, Township, Lahore, Pakistan, between April 2020 to April 2021. The CMT, total energy, and sum total of shots used were recorded. The thickness of the central macula was measured preoperatively and postoperatively after two weeks. The paired sample t-test was used to find out any significant changes in CMT pre and two weeks postoperatively. The comparison of changes in CMT to age, energy, and the total number of shots was made through Pearson correlation. Means of CMT were compared using an independent sample t-test, at two weeks postoperatively among two energy groups. Results No statistically significant differences were found between preoperative and two weeks postoperative values of the CMT (P-value= 0.209). No significant difference was found in CMT statistically among the two energy groups (p=0.11). The patient's age, sum total of laser shots, and aggregate of laser energy did not have any significant correlation with CMT changes. The time period between cataract surgery and ND-YAG surgery showed a moderately positive correlation with a p-value of 0.01. Conclusion The current study revealed that ND-YAG capsulotomy does not affect the CMT significantly postoperatively. The patient's age, total energy applied, and the total number of laser shots used do not influence the macular thickness. However, the length of duration from the last cataract surgery to the current surgery was significantly associated with a change in the CMT.

Keywords: central macular thickness; nd-yag laser; optical coherence tomography (oct); posterior capsule opacification; posterior capsulotomy.