Neodymium : YAG laser posterior capsulotomies performed by residents at a Veterans Administration hospital

Purpose: To assess the initial efficacy of neodymium:YAG (Nd:YAG) laser pos terior capsulotomies performed by residents at a teaching institution and t o evaluate the associated complications over an extended follow-up. Setting: Department of Ophthalmology, Edward Hines, Jr. Veterans Administra tion Hospital, Hines, Illinois, USA. Methods: This retrospective noncomparative case review comprised 212 pseudo phakic eyes having Nd:YAG laser posterior capsulotomies from April 1992 thr ough March 1995. Evaluated were postoperative changes in best corrected vis ual acuity (BCVA), intraocular pressure (IOP) elevations, and complications related to the procedure. Results: In all 212 eyes, Snellen visual acuity was obtained at least 1 wee k after the capsuiotomy. The BCVA in 96 eyes (45.3%) improved by 3 or more lines, in 43(20.3%) by 2 lines, and in 51 (24.1%) by 1 line. Nineteen eyes (9.0%) did not improve by 1 or more lines, and 3 eyes (1.4%) had decreased Snellen acuity. All but 4 eyes with less than 1 line of improvement had und erlying ocular pathology or a previous incomplete capsulotomy. For evaluati on of postoperative complications, long-term follow-up was available for 13 3 of 212 eyes (62.7%). The mean follow-up for this group was 3.18 years. Po stoperative complications were found in 14 of these eyes (10.5%). Nine (6.8 %) had a rise in IOP greater than 10 mm Hg after the capsulotomy. One eye ( 0.8%) developed a persistent iritis, 2 (1.5%) had vitreous prolapse into th e anterior chamber, and 2 (1.5%) developed rhegmatogenous retinal detachmen ts. Conclusion: Postoperative Snellen acuity results and complication rates com pare favorably with those in previous studies. The results indicate that Nd :YAG laser posterior capsulotomies performed by residents with attending su pervision are safe, effective, and early a low associated complication rate over a long follow-up. J Cataract Refract Surg 2000; 26:597-601 (C) 2000 A SCRS and ESCRS.