A CLINICAL STUDY OF NEODYMIUM YAG LASER CAPSULOTOMY- THE PATTERN AND ENERGY USED FOR VARIOUS GRADES OF PCO AND OUTCOME

Background :The denser the PCO there is tendency of more energy to be used, Nd: YAG capsulotomy is associated with significant anterior and posterior segment complications. There are no much studies on impact of Nd: YAG laser energy on the rate of complications and opening patterns of capsulotomy on visual function. Objectives: To find out association between the grade and type of PCO with energy used. 2] To compare the visual outcome and complications between circular pattern and cruciate pattern PCO capsulotomy Methodology: The patients are divided into group A and B, group A underwent cruciate and group B underwent circular pattern capsulotomy. A Q- switched Nd: YAG laser Initial setting of 1mJ and subsequent increase of 0.5 mJ as necessary used to make opening in the posterior capsule and the number of pulses used to create capsulotomy and summated total laser energy was noted in each case. Patients were followed for 6 months and analyzed. Results: In this study age of the patients ranged from 6 years to 86 years and the mean age was 62.3+/- 18.2. Maximum energy is required for grade 4 (46.6 mJ) and Least is for grade 1(9.7) More energy is required for fibrous (39.2mJ) and least is for membranous (26.7mJ). In cases who underwent circular pattern. Complications like IOL pitting and uveitis are common in circular pattern compared cruciate pattern, where IOP spikes is a common complication. Conclusion: Grade and Type of PCO significantly influenced laser energy levels required for capsulotomy, whereas Complications are significantly more common when total laser energy was higher. This new technique of cruciate pattern Nd: YAG posterior laser capsulotomy can be performed safely but visual prognosis is better in circular pattern of capsulotomy.