The Asia-Pacific Journal of Ophthalmology

Asia-Pacific Journal of Ophthalmology:

Issue 5, September/October 2018 Review Article

Does Nd:YAG Capsulotomy Increase the Risk of Retinal Detachment?

Grzybowski, Andrzej; Kanclerz, Piotr



Author Information


From the *Department of Ophthalmology, University of Warmia and Mazury, Olsztyn; †Institute for Research in Ophthalmology, Foundation for Ophthalmology Development, Poznan; and ‡Department of Ophthalmology, Medical University of Gdańsk, Poland.


Reprints: Andrzej Grzybowski, MD, PhD, MBA, 60-554 Gorczyczewskiego 2/3 Poznan, Poland. E-mail: ae.grzybowski@gmail.com.



Abstract


Laser capsulotomy is accepted as a standard and effective treatment for posterior capsule opacification. It is generally believed that neodymium:YAG (Nd:YAG) capsulotomy is related to an increased risk of retinal detachment (RD). The aim of this study was to evaluate the association between Nd:YAG capsulotomy and risk for developing RD. A PubMed and Medline search was conducted using the terms “retinal detachment” and “Nd:YAG laser capsulotomy.” Of the articles retrieved by this method, all publications in English and abstracts of non-English publications were reviewed. The literature analysis presented no convincing evidence supporting the association between Nd:YAG capsulotomy and increased risk for developing RD. The existing discrepancy between some studies might be related to inadequate group sizes, short observation period, and co-existing disorders. We also reviewed the possible risk factors for RD after Nd:YAG capsulotomy and found no association with preceding surgical approach, existing posterior vitreous detachment, and intraocular lens design. Myopic patients should be treated with caution, as it cannot be concluded that Nd:YAG capsulotomy does not increase RD rate in this cohort. Treatment energy should be as low as possible, as high energy levels and anterior hyaloid damage might increase the chance for RD development. Cataract surgery itself is a potential RD risk factor, particularly after intraoperative capsule complications.




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