Nd:YAG laser capsulotomy vs needle aspiration in intumescent cataracts: Comparative study of complications and outcomes

Ceylan A., Aydin F. O., KARAPAPAK M., Aydin S., ÖZAL S. A., Yildirim Y.

Journal of Cataract and Refractive Surgery, cilt.50, sa.11, ss.1123-1127, 2024 (SCI-Expanded, Scopus)

Özet

Purpose:To compare the complications and postoperative outcomes of Nd:YAG laser anterior capsulotomy vs a needle aspiration approach for capsulorhexis in patients with intumescent cataracts.Setting:University of Health Sciences, Basaksehir Cam and Sakura City Hospital Department of Ophthalmology, Istanbul, Turkey.Design:Retrospective, cross-sectional study.Methods:Patients with intumescent cataract were divided into 2 groups. Group 1 (37 eyes) underwent Nd:YAG laser capsulotomy preoperatively, which reduced lens pressure. In Group 2 (31 eyes), the capsulorhexis was completed by reducing the intralenticular pressure by needle aspiration and then gradually expanding the capsule. Demographics, pre/postoperative parameters, complications, and surgical times were analyzed.Results:68 eyes of 68 patients were evaluated. Age and sex exhibited no significant differences between groups. Group 2 had more complications than Group 1 (P =.041). Specifically, no capsular tear extensions were seen in Group 1 while 4 patients in Group 2 had tears extending to the lens periphery. Group 1 showed a significant decrease in surgical maneuvers and time (P =.028) while no significant difference was found in effective phacoemulsification time (P =.076).Conclusions:Nd:YAG laser capsulotomy effectively prevented capsular extensions and reduced surgical time in intumescent cataracts. This technique provides a safe alternative to traditional methods, potentially reducing intraoperative risks and improving surgical efficiency. The findings support Nd:YAG laser anterior capsulotomy as a viable approach for capsulorhexis in intumescent cataracts, emphasizing its potential benefits in reducing complications and enhancing surgical outcomes.