Aliki Liaska, Dpt of Ophthalmology,

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Presentation transcript:

POSTERIOR CAPSULE OPACIFICATION TREATMENT: NdYAG LASER VS POSTERIOR CAPSULE POLISHING Aliki Liaska, Dpt of Ophthalmology, General Hospital of Lamia, Lamia, Greece

Posterior capsule opacification the most common late complication of uncomplicated cataract surgery. common approach Nd: YAG laser posterior capsulotomy convenient but… associated with various complications damage to the IOL, cystoid macular oedema, rhegmatogenous retinal detachment, intraocular pressure elevation, posterior IOL subluxation or dislocation, chronic endophthalmitis and…floaters, poor visibility of the retina periphery alternative method for treatment?

Purpose Pooled data suggest that posterior capsule opacification (PCO) treatment with YAG LASER is safe and effective. However in selected cases such as high myopes, silicone oil filled eys or massive PCO it would be worth considering an alternative method. Posterior capsule polishing allows the integrity of posterior capsule without compromising vision.

Patients/Method 67 patients (67 eyes) with PCO without central capsular fibrosis underwent posterior capsule polishing. Two sideport incisions were made by 30ᵒ blade. And an anterior chamber maintainer was inserted . Posterior capsule polishing was performed with a Simcoe canula attached to a 5ml syringe.

Technique The canula was inserted through anterior capsulorhexis underneath the intraocular lens(IOL). Iris hooks were used in cases of inadequate mydriasis and enlargement of anterior capsulorhexis was necessary in a few cases to uncover the IOL edge.

Results 6 days later… Follow up time ranges from 6 months to 2 years. All patients experienced improvement of vision from the next day. Visual acuity ranged from 0.8 to 1.0. There were three cases of posterior capsule rupture without vitreous loss. In two patients the procedure was repeated after one year. 6 days later…

Special considerations in… Poor zonular support (PXS syndrome, pseudophacodonesis) Poor mydriasis Preexisting tear of the anterior capsule Small capsulorrhexis Advantageous (vs YAG capsulotomy) in Young patients Myopes Diabetics

Conclusions treatment of PCO by polishing of the posterior capsule is a safe procedure which allows the maintenance of the integrity of the posterior capsule. It can be repeated and it is advantageous in patients with various forms of fundus pathology and especially those subject to vitreoretinal surgery as it allows wide field visualization of the posterior segment.