EVALUATION OF VISUAL FUNCTION FOLLOWING NEODYMIUM, YAG LASER POSTERIOR CAPSULOTOMY

Purpose: Improvement in visual acuity is the primary endpoint for succ essful neodymium:YAG (Nd:YAG) laser posterior capsulotomy for posterio r capsule opacification. There is limited information on related param eters of visual function that may also improve after laser treatment. The authors evaluate changes in contrast sensitivity and glare disabil ity, aside from visual acuity, following Nd:YAG laser posterior capsul otomy, Methods: Measurements of visual acuity, contrast sensitivity (u sing the Pelli-Robson chart), and glare disability (using the Brightne ss Acuity Tester [Mentor O & O, Inc., Norwell, MA]) were obtained from 24 consecutive patients before and after Nd:YAG laser posterior capsu lotomy, Glare testing was done with both the Pelli-Robson and Early Tr eatment Diabetic Retinopathy Study (ETDRS) charts, The degree of glare disability was indicated by the difference between visual function wi th glare (at medium and high settings) and without glare. Prelaser mea surements were taken within 2 weeks prior to treatment, and postlaser measurements were obtained within 3 months after treatment. Only one e ye per patient was evaluated, Results: Mean differences between prelas er and postlaser measurements were significantly different from zero: (1) Contrast sensitivity, mean difference = 0.24 log units (P < 0.0001 ); (2) High glare disability using Pelli-Robson chart, mean difference = 0.15 log units (P = 0.004); (3) Visual acuity using ETDRS chart, me an difference = 11 letters (P < 0.0001); 4) High glare disability usin g ETDRS chart, mean difference = 7 letters (P = 0.005). Conclusions: U sing the above methods for visual function testing, Nd:YAG laser capsu lotomy is shown to significantly improve visual acuity, contrast sensi tivity, and glare disability measurements as compared with prelaser va lues, The ophthalmologist may find it helpful to document the last two measurements prior to Nd:YAG laser capsulotomy, especially in patient s who have good visual acuity but complain of glare sensitivity.