The Effectiveness of Nd: YAG Laser Capsulotomy for the Treatment of Posterior Capsule Opacification in Children With Acrylic Intraocular Lenses

David R. Stager, Xiaohong Wang, David R. Weakley, Joost Felius

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Introduction: Acrylic intraolcular lenses (IOLs) may result in lower rates of posterior capsular opacification (PCO) than poly(methyl methacrylate) lenses in children. Nonetheless, PCO frequently occurs eventually, especially in younger children. Here, we evaluated the success of neodymium-doped yttrium-aluminum-garnet (Nd:YAG) laser capsulotomy for the management of PCO after acrylic IOL implantation without primary capsulectomy. Methods: We reviewed 73 eyes in 57 children (age 23 months to 12 years; median, 6.4 years) who underwent Nd:YAG laser capsulotomy after AcrySof IOL implantation and who had at least 3 months follow-up (range, 3-92 months; median, 25 months). The effectiveness of laser treatment was evaluated in terms of the need for repeat laser procedures or intraocular surgery to clear the visual axis. Results: Fifty-one eyes (70%) maintained a clear visual axis after a single Nd:YAG procedure, 10 eyes (84% cumulative) after 2 Nd:YAG procedures, and another 3 eyes (88% cumulative) after 3 Nd:YAG procedures. Six eyes (8%) required pars plana membrane removal to clear the visual axis, whereas 3 eyes (4%) continue to need treatment. Life table analysis showed that the probability of continuing success after 24 months with a single Nd:YAG procedure is 68% (95% confidence interval 53-83%). In younger children (age < 4 years), this rate probability was lower than in older children (35% vs. 74%; P = 0.022). Two eyes developed mild transient elevated intraocular pressure. In 1 eye, the IOL was dislocated and replaced. Discussion: Nd:YAG laser capsulotomy is an acceptable option for the management of PCO after AcrySof IOL implantation in children and produces complications infrequently.

Original languageEnglish (US)
Pages (from-to)159-163
Number of pages5
JournalJournal of AAPOS
Volume10
Issue number2
DOIs
StatePublished - Apr 2006

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Posterior Capsulotomy
Capsule Opacification
Intraocular Lenses
Solid-State Lasers
Lenses
Neodymium
Therapeutics
Lasers
Life Tables
Temazepam
Polymethyl Methacrylate
Intraocular Pressure
Confidence Intervals

ASJC Scopus subject areas

  • Ophthalmology

Cite this

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title = "The Effectiveness of Nd: YAG Laser Capsulotomy for the Treatment of Posterior Capsule Opacification in Children With Acrylic Intraocular Lenses",
abstract = "Introduction: Acrylic intraolcular lenses (IOLs) may result in lower rates of posterior capsular opacification (PCO) than poly(methyl methacrylate) lenses in children. Nonetheless, PCO frequently occurs eventually, especially in younger children. Here, we evaluated the success of neodymium-doped yttrium-aluminum-garnet (Nd:YAG) laser capsulotomy for the management of PCO after acrylic IOL implantation without primary capsulectomy. Methods: We reviewed 73 eyes in 57 children (age 23 months to 12 years; median, 6.4 years) who underwent Nd:YAG laser capsulotomy after AcrySof IOL implantation and who had at least 3 months follow-up (range, 3-92 months; median, 25 months). The effectiveness of laser treatment was evaluated in terms of the need for repeat laser procedures or intraocular surgery to clear the visual axis. Results: Fifty-one eyes (70{\%}) maintained a clear visual axis after a single Nd:YAG procedure, 10 eyes (84{\%} cumulative) after 2 Nd:YAG procedures, and another 3 eyes (88{\%} cumulative) after 3 Nd:YAG procedures. Six eyes (8{\%}) required pars plana membrane removal to clear the visual axis, whereas 3 eyes (4{\%}) continue to need treatment. Life table analysis showed that the probability of continuing success after 24 months with a single Nd:YAG procedure is 68{\%} (95{\%} confidence interval 53-83{\%}). In younger children (age < 4 years), this rate probability was lower than in older children (35{\%} vs. 74{\%}; P = 0.022). Two eyes developed mild transient elevated intraocular pressure. In 1 eye, the IOL was dislocated and replaced. Discussion: Nd:YAG laser capsulotomy is an acceptable option for the management of PCO after AcrySof IOL implantation in children and produces complications infrequently.",
author = "Stager, {David R.} and Xiaohong Wang and Weakley, {David R.} and Joost Felius",
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T1 - The Effectiveness of Nd

T2 - YAG Laser Capsulotomy for the Treatment of Posterior Capsule Opacification in Children With Acrylic Intraocular Lenses

AU - Stager, David R.

AU - Wang, Xiaohong

AU - Weakley, David R.

AU - Felius, Joost

PY - 2006/4

Y1 - 2006/4

N2 - Introduction: Acrylic intraolcular lenses (IOLs) may result in lower rates of posterior capsular opacification (PCO) than poly(methyl methacrylate) lenses in children. Nonetheless, PCO frequently occurs eventually, especially in younger children. Here, we evaluated the success of neodymium-doped yttrium-aluminum-garnet (Nd:YAG) laser capsulotomy for the management of PCO after acrylic IOL implantation without primary capsulectomy. Methods: We reviewed 73 eyes in 57 children (age 23 months to 12 years; median, 6.4 years) who underwent Nd:YAG laser capsulotomy after AcrySof IOL implantation and who had at least 3 months follow-up (range, 3-92 months; median, 25 months). The effectiveness of laser treatment was evaluated in terms of the need for repeat laser procedures or intraocular surgery to clear the visual axis. Results: Fifty-one eyes (70%) maintained a clear visual axis after a single Nd:YAG procedure, 10 eyes (84% cumulative) after 2 Nd:YAG procedures, and another 3 eyes (88% cumulative) after 3 Nd:YAG procedures. Six eyes (8%) required pars plana membrane removal to clear the visual axis, whereas 3 eyes (4%) continue to need treatment. Life table analysis showed that the probability of continuing success after 24 months with a single Nd:YAG procedure is 68% (95% confidence interval 53-83%). In younger children (age < 4 years), this rate probability was lower than in older children (35% vs. 74%; P = 0.022). Two eyes developed mild transient elevated intraocular pressure. In 1 eye, the IOL was dislocated and replaced. Discussion: Nd:YAG laser capsulotomy is an acceptable option for the management of PCO after AcrySof IOL implantation in children and produces complications infrequently.

AB - Introduction: Acrylic intraolcular lenses (IOLs) may result in lower rates of posterior capsular opacification (PCO) than poly(methyl methacrylate) lenses in children. Nonetheless, PCO frequently occurs eventually, especially in younger children. Here, we evaluated the success of neodymium-doped yttrium-aluminum-garnet (Nd:YAG) laser capsulotomy for the management of PCO after acrylic IOL implantation without primary capsulectomy. Methods: We reviewed 73 eyes in 57 children (age 23 months to 12 years; median, 6.4 years) who underwent Nd:YAG laser capsulotomy after AcrySof IOL implantation and who had at least 3 months follow-up (range, 3-92 months; median, 25 months). The effectiveness of laser treatment was evaluated in terms of the need for repeat laser procedures or intraocular surgery to clear the visual axis. Results: Fifty-one eyes (70%) maintained a clear visual axis after a single Nd:YAG procedure, 10 eyes (84% cumulative) after 2 Nd:YAG procedures, and another 3 eyes (88% cumulative) after 3 Nd:YAG procedures. Six eyes (8%) required pars plana membrane removal to clear the visual axis, whereas 3 eyes (4%) continue to need treatment. Life table analysis showed that the probability of continuing success after 24 months with a single Nd:YAG procedure is 68% (95% confidence interval 53-83%). In younger children (age < 4 years), this rate probability was lower than in older children (35% vs. 74%; P = 0.022). Two eyes developed mild transient elevated intraocular pressure. In 1 eye, the IOL was dislocated and replaced. Discussion: Nd:YAG laser capsulotomy is an acceptable option for the management of PCO after AcrySof IOL implantation in children and produces complications infrequently.

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