Intraocular Lens Position and Anterior Chamber Parameters Evaluation After Nd:YAG Laser Posterior Capsulotomy for Posterior Capsular Opacification Using Anterior Segment Swept-Source Optical Coherence Tomography

Abstract

Purpose: To evaluate the effect of neodymium-doped yttrium aluminum garnet (Nd:YAG) laser capsulotomy on intraocular lens (IOL) position and anterior segment parameters with a new swept-source anterior segment optical coherence tomography (AS-OCT) device (Anterion®, Heidelberg Engineering GmbH). Patients and Methods: A total of 50 eyes from 50 consecutive patients were included. All patients had visually significant posterior capsular opacification (PCO) after uneventful phacoemulsification surgery with manual capsulorhexis and single-piece C-loop acrylic IOL implantation (AcrySof® SA60AT) and were treated with Nd:YAG laser. Anterior segment images were captured with Anterion® in non-dilated conditions before and one month after the procedure. In the “Metrics App”, we collected data of the anterior chamber angle (ACA) 3 and 9 o’clock, the anterior chamber depth (ACD), the anterior chamber volume (ACV), and the central corneal thickness (CCT). We also collected demographic and clinical data [age, gender, months from surgery to Nd: YAG capsulotomy, pre-and post-capsulotomy corrected distance visual acuity (CDVA) and spherical equivalent, and axial length]. Results: We did not find a statistically significant difference in ACD after the Nd:YAG capsulotomy (3.96 ± 0.55 vs 3.97 ± 0.55 mm, p = 0.10). In 28 patients, we noted a backward movement of the IOL; in the remaining 22, the IOL moved forward or did not change at all. We did not observe significant changes in ACA at the 3 and 9 o’clock reference points, ACV, or CCT. There was an improvement in CDVA after the procedure (0.37 ± 0.21 vs 0.12 ± 0.27 logMAR, p = 0.015), without statistically significant differences in SE (−0.15 ± 0.84 vs −0.25 ± 0,93, p = 0.42). Axial length was not correlated with ACD variations after the procedure (p = 0.67). Conclusion: Our results show that Nd:YAG laser capsulotomy does not change the axial position of a single-piece C-loop acrylic IOL inside the capsular bag, as well as other anterior chamber parameters.