Hayashi Eye Hospital, Fukuoka, Japan

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Hayashi Eye Hospital, Fukuoka, Japan Anterior capsule relaxing incisions with neodymium:YAG laser for patients at high-risk for anterior capsule contraction Ken Hayashi, MD Motoaki Yoshida, MD Shin-ichi Manabe, MD Hideyuki Hayashi, MD Hayashi Eye Hospital, Fukuoka, Japan The authors have no financial interest in the subject matter in this e-poster.

Purpose Our previous study showed that three anterior capsule relaxing incisions created with Nd:YAG laser in the early postoperative period prevent anterior capsule contraction in nonpathologic eyes. This study was designed to evaluate the effect of anterior capsule relaxing incisions on preventing extensive capsule contraction in high-risk eyes, such as those with primary angle closure, pseudoexfoliation syndrome, or diabetic retinopathy.

Patients and Methods Patients: 90 patients scheduled for cataract surgery 1) Primary angle-closure 30 patients 2) Pseudoexfoliation syndrome 30 patients 3) Diabetic retinopathy 30 patients ※ All patients had 3 anterior capsule relaxing incisions in either eye at 3 days postop. and sham treatment in fellow eye. Methods: 1) Degree of anterior capsule contraction ① Area of anterior capsule opening (mm2) ② Percentage of opening area (%) 2) Possible complications of anterior capsule relaxing incisions ③ IOL decentration (mm) and tilt (°) ④ Anterior chamber depth (mm) ⑤ Posterior capsule opacification value (CCT) At 3 days (baseline), and at 1, 3, 6 months after baseline

3 anterior capsule relaxing incisions

Patients demographics 　 Capsulotomy　 No-capsulotomy group 　　　 group 　　　P value Number or eyes Age Left/Right MRSE (D) Astigmatism (D) Axial length IOL power (D) MRSE = Manifest spherical equivalent value *No statistically significant difference　 42 69.6 ± 7.7 41/43 -0.92 ± 0.54 0.89 ± 0.63 23.1 ± 1.3 22.3 ± 3.6 　　　 42 69.6 ± 7.7 　　 43/41 -1.11 ± 0.77 0.94 ± 0.59 23.0 ± 1.3 22.5 ± 3.4 - 0.8774* 0.1037* 0.5083* 0.8602* 0.9015*

Comparison of the mean area of the anterior capsule opening Capsulotomy 　No-capsulotomy　 group group　　　　　P value Primary angle closure 　 Baseline 　3 months 　 6 months Pseudoexfoliation 　Baseline 　 3 months 　6 months Diabetic retinopathy 26.3 ± 2.9 22.6 ± 3.9 22.0 ± 4.3 26.3 ± 4.1 23.4 ± 6.4 22.7 ± 6.7 27.3 ± 3.5 25.6 ± 5.7 26.2 ± 6.1 26.9 ± 4.0 19.0 ± 5.6 18.6 ± 5.3 26.7 ± 5.4 20.2 ± 8.2 20.1 ± 6.6 27.5 ± 3.4 22.7 ± 6.0 23.0 ± 5.8 0.6100 0.0052* 0.0047* 0.9673 0.0996 0.1955 0.8548 0.0805 0.0632 *Statistically significant difference

Comparison of the mean percent reduction in anterior capsule opening area (%) Capsulotomy No-capsulotomy　　　 group group P value *Statistically significant difference Primary angle closure 　 1 month 　3 months 　 6 months Pseudoexfoliation 　1 month 　 3 monthsz 　6 months Diabetic retinopathy 8.6 ± 17.1 13.4 ± 16.8 15.2 ± 19.1 3.4 ± 18.1 11.0 ± 22.2 13.0 ± 25.3 0.8 ± 11.6 6.0 ± 19.1 3.8 ± 20.8 16.1 ± 17.4 28.7 ± 20.6 29.8 ± 20.4 10.5 ± 13.6 24.8 ± 26.6 25.0 ± 25.1 8.2 ± 13.6 18.1 ± 17.6 16.5 ± 17.1 0.0428* 0.0050* 0.0105* 0.0573 0.0281* 0.0493* 0.0619 0.0404* 0.0268*

Comparison of the IOL decentration and tilt, and anterior chamber depth Decentration (mm) 　 Baseline 　3 months 　 6 months Tilt (°) 　Bseline 　 3 months 　6 months AC depth (mm) 0.18 ± 0.13 0.17 ± 0.09 1.19 ± 0.60 1.36 ± 0.61 1.11 ± 0.52 3.9 ± 0.3 0.18 ± 0.12 0.18 ± 0.10 1.32 ± 0.77 1.32 ± 0.61 1.17 ± 0.56 3.9 ± 0.4 0.9028* 0.5063* 0.6387* 0.3429* 0.6696* 0.2822* 0.4902* 0.7475* 0.9835* Capsulotomy No-capsulotomy group 　　　　　　group　　　　　 P value *No statistically significant difference

Capsulotomy No-capsulotomy

Conclusions Anterior capsule relaxing incisions created with an Nd:YAG laser in the early period after cataract surgery decreased anterior capsule contraction in high-risk patients. 2) The early anterior capsule incisions did not cause adverse events. 3) A preventive anterior capsulotomy should be considered in high-risk eyes, especially those with zonular dehiscence.