# Evaluation of Changes in Central Macular Thickness After Neodymium-Doped Yttrium Aluminum Garnet (Nd:YAG) Posterior Capsulotomy: An Optical Coherence Tomography-Based Prospective Observational Study

## TL;DR

This study examines how macular thickness changes after laser treatment for a common eye condition following cataract surgery.

## Contribution

The study provides new OCT-based evidence on the temporary increase in central macular thickness after Nd:YAG capsulotomy.

## Key findings

- BCVA significantly improved after Nd:YAG laser treatment for posterior capsular opacification.
- Central macular thickness increased significantly at three weeks but returned to non-significant levels by eight weeks.
- Intraocular pressure remained stable within a normal range throughout the follow-up period.

## Abstract

Background

After cataract surgery, one of the most common complications causing diminution of vision is posterior capsular opacification (PCO). Neodymium-doped yttrium aluminum garnet (Nd:YAG) laser therapy is currently the most popular option for treating PCO, as it is a fast, non-invasive, and successful procedure.

Methodology

This prospective observational study was conducted at a tertiary eye care center in central India. A total of 64 pseudophakic patients were included. Preoperative evaluation included a detailed demographic history and complete ophthalmological examination, including visual acuity, intraocular pressure (IOP), and central macular thickness (CMT). All patients underwent Nd:YAG laser capsulotomy for PCO. Following laser treatment, IOP, best-corrected visual acuity (BCVA), and CMT were evaluated after three and eight weeks. Optical coherence tomography (OCT) was used to measure CMT. The data analysis was done using suitable statistical tests.

Results

A total of 64 patients who met the inclusion criteria were enrolled. There was a significant and stable improvement in BCVA, with mean BCVA improving from baseline 0.82 ± 0.15 logMAR preoperatively to 0.12 ± 0.09 logMAR postoperatively (p < 0.001). Regarding CMT values, post-laser macular thickness at three weeks (mean ± SD = 241.50 ± 10.76) was significantly increased (p < 0.001) compared to pre-laser macular thickness (mean ± SD = 222.89 ± 9.23); however, it was statistically non-significant at eight weeks (p = 0.08). Most patients remained within the 10-16 mmHg IOP range throughout the follow-up period.

Conclusions

Nd:YAG laser posterior capsulotomy is a quick, safe, and non-invasive procedure for PCO. Increased macular thickness was reported as a complication after performing YAG laser posterior capsulotomy, lasting for a substantial period, which was revealed on follow-up with OCT. As this was not clinically observed, it did not necessitate regular prophylactic treatment.