Abstract
Short-term observation following Nd-YAG laser capsulotomy indicates that serious elevation of intra-ocular pressure may occur, unrelated to the amount of energy used.
In this study the IOP in 3 groups of 10 pseudophakic patients undergoing Nd-YAG laser posterior capsulotomy was measured before capsulotomy and 2 and 4 hours afterwards, using the fellow-eye as control. The first group received no medication, the second received timolol 1/2% eyedrops preoperatively, the third group a combination of timolol 1/2% and 1 tablet of acetazolamide 250 mg systemically. Pretreatment with timolol 0.5% minimizes IOP-rise but does not give complete protection.
The combination of timolol 0.5% with 1 tablet of acetazolamide 250 mg proves to be a safe procedure for the prevention of IOP-rise after YAG laser capsulotomy.
To prevent other complications it is advisable to make a small capsulotomy of 2–3 mm diameter using as little energy as possible. Also a defocussing system in the laser is a great advantage. Indomethacin drops during a period of 6 weeks after Nd-YAG laser capsulotomy should prevent cystoid macular edema.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Aron-Rosa DS, Aron JJ and Cohn HC (1984) Use of a pulsed picosecond ND:YAG laser in 6664 cases. Amer Intra-Ocular Implant Soc J 10:35–39
Boen-Tan TN and Stilma JS (1985) Out-patient treatment of after cataract with the neodymium-Yag laser (Poliklinische nastaarbehandeling met deneodymium-Yag-laser). Ned Tijdschr Geneeskd 129:2411–2413
Fankhauser F (1983) The Q switched laser: principles and clinical results. In: Trokel SL (ed) YAG Laser Ophthalmic Microsurgery. Norwalk, Appleton-Century-Crofts, pp 101–146
Keates RH, Steinert RF, Puliafito CA and Maxwell SK (1984) Long-term follow-up of Nd:YAG laser posterior capsulotomy. Amer Intra-Ocular Implant Soc J 10:164–168
Leys MJJ, Pameijer JH and de Jong PTVM (1985) Intermediate-term changes in intra ocular pressure after Neodymium YAG laser posterior capsulotomy. Amer J Ophthal 100:332–333
Parker WT, Clorfeine GS and Stocklin RD (1984) Marked intraocular pressure rise following Nd-YAG laser capsulotomy. Ophthalmic Surg 15:103–104
Stark WJ, Worthen D, Holladay JT and Murray G (1985) Neodymium:YAG lasers. An FDA Report Ophthalmology 92:209–212
Steinert RF and Puliafito CA (1985) The Nd-YAG Laser in Ophthalmology. Philadelphia, Saunders
Trokel SL (1983) YAG Laser Ophthalmic Microsurgery. Norwalk, Appleton-Century Crofts
Blackwell C, Hirst LW and Kinnas SJ (1985) Neodymium-YAG capsulotomy and potential blindness. Amer J Ophthal 98:521–522
Kerr Muir MG and Sherrard ES (1985) Damage to the corneal endothelium during Nd/YAG photodisruption. Brit J Ophthal 69:77–85
Vine AK (1984) Ocular hypertension following Nd:YAG laser capsulotomy: A potentially blinding complication. Ophthalmic Surg 15:283–284
Zink H, Birngruber R, Boergen KP and Gabel VP (1984) Side effects using short-pulsed Neodym lasers in intraocular microsurgery. Docum Ophthal. Proc Ser 36:171–177
Channell MM and Beckman H (1984) Intraocular pressure changes after Neodymium-YAG laser posterior capsulotomy. Arch Ophthal 102:1024–1026
Terry AC, Stark WJ, Maumenee AE and Fagadau W (1983) Neodymium Yag laser for posterior capsulotomy. Amer J Ophthal 96:716–720
Gaasterland DE (1985) Discussion (on a clinical study) Ophthalmology 92:640
Kraff MC, Sanders DR, Lieberman HL (1985) Intraocular pressure and the corneal endothelium after neodymium-YAG laser posterior capsulotomy: Relative effects of aphakia and pseudophakia. Arch Ophthal 103:511–514
Richter CU, Arzeno G, Pappas HR, Arrigg CA, Wasson P and Steinert RF (1985) Prevention of intraocular pressure elevation following Neodymium-YAG laser posterior capsulotomy. Arch Ophthal 103:912–915
Haefliger E (1984) Der Neodym-AYG-Laser in der Katarakt-Chirugie. Klin Mbl Augenheilk 184:431–432
Stilma JS and Boen-Tan (1986) Timolol and intra-ocular pressure elevation following Neodymium:YAG laser surgery. Docum Ophthal 61:233–239
Wizemann A and Jacobi KW (1984) Nd-YAG-Laserkapsulotomie bei intraokularlinsen mit inverser Optik. Klin Mbl Augenheilk 184:175–179
Brown SVL, Thomas JV, Belcher CD and Simmons RJ (1985) Effect of pilocarpine in treatment of intraocular pressure elevation following neodymium: YAG laser posterior capsulotomy. Ophthalmology 92:354–359
Schrems W, Eichelbrönner O and Krieglstein GK (1984) The intermediate IOP response of ND-YAG-Laser iridotomy and its prophylactic treatability. Acta Ophthal 62:673–680
Schrems W (1985) Der Zusammenbruch der Blut-Kammerwasser-Schranke nach Lasertrauma — prophylaktische Pharmakotherapie mit Prostaglandin-Hemmsubstanzen. Klin Mbl Augenheilk 186:29–31
Schrems W, Glaab-Schrems E and Krieglstein GK (1985) Augendrucksteigerungen bie der Nachstarchirurgie mit dem Neodym-YAG-laser. Klin Mbl Augenheilk 187:14–16
Forbes M, Pico G and Grolman B (1974) A noncontact applanation tonometer. Arch Ophthal 91:134–140
Fankhauser F, Lörtscher H and van der Zypen E (1982) Clinical studies on high and low power laser radiation upon some structures of the anterior and posterior segments of the eye. Int Ophthal 5:15–32
Riquin D, Fankhauser F and Lörtscher H (1983) Contact glasses for use with high power lasers. Two new contact glasses for microsurgery at the iris, in the pupillary and the retropupillary space. Int Ophthal 6:191
Holloday JT, Bishop JE and Lewis JW (1985) The optimal size of a posterior capsulotomy. Amer Intra-Ocular Implement Soc J 11:18–19
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Boen-Tan, T.N., Stilma, J.S. Prevention of IOP-rise following Nd-YAG laser capsulotomy with pre-operative timolol eye-drops and 1 tablet acetazolamide 250 mg systematically. Doc Ophthalmol 64, 59–67 (1986). https://doi.org/10.1007/BF00166686
Issue Date:
DOI: https://doi.org/10.1007/BF00166686