Outcomes Following Therapeutic Nd:Yag Anterior Capsule Expansion In Pseudophakic Eyes: A Retrospective Case Series
Published 2025 - 43rd Congress of the ESCRS
Reference: FP25.06 | Type: Free paper | DOI: 10.82333/tsqt-e437
Authors: Shady Awwad* 1 , Yara Bteich 2 , Jad F. Assaf 3 , Farhad Hafezi 4 , Soosan Jacob 5
1American University of Beirut ,Beirut,Lebanon, 2American University of Beirut,Beirut,Lebanon, 3OHSU,Portland,United States, 4ELZA Institute,Zurich,Switzerland, 5Dr. Agarwal Hospital,Chennai,India
Purpose
To evaluate postoperative visual outcomes following therapeutic Nd:YAG anterior capsule expansion in eyes that have previously undergone monofocal lens surgery.
Setting
London Vision Clinic, London, UK
Methods
A retrospective, single-centre, consecutive case series was conducted involving four patients who were symptomatic of visual disturbances and underwent therapeutic bilateral Nd:YAG anterior capsule expansion following monofocal lens surgery. Preoperative assessments included comprehensive ophthalmological evaluations including pupil size measurements and aberrometry in order to conduct a detailed analysis of the capsule dimensions using a best-fit circle method. These preoperative evaluations revealed that the anterior capsule edges were encroaching onto the scotopic pupil, a potential cause of the visual symptoms. A Nd:YAG laser procedure was subsequently performed to enlarge the anterior capsule to resolve the visual disturbances.
Results
In this case series, the mean pupil diameter before the Nd:YAG procedure was 5.92 ± 0.34 mm (5.41 to 6.40 mm), while the mean anterior capsule diameter was 4.02 ± 0.34 mm (3.80 to 4.86 mm). After the Nd:YAG laser treatment, there was a statistically significant increase in the capsule diameter (P < 0.05), indicating a successful expansion. Postoperative follow-up revealed a marked improvement in visual symptoms and subjectively, all participants reported a reduction in visual disturbances. Objective measures also demonstrated significant improvement, with higher-order aberrations (HOAs) decreasing from 0.71 to 0.39 (P < 0.05). Additionally, there were improvements to the point spread function (PSF) and ocular scatter index (OSI).
Conclusions
Therapeutic Nd:YAG anterior capsule expansion is an effective and reliable method for improving visual disturbances in pseudophakic eyes. This technique significantly reduces higher-order aberrations and improves overall optical quality, offering a promising solution for patients suffering from visual disturbances following monofocal intraocular lens implantation.