Laser posterior capsulotomy in case of the 1st degree of posterior capsular opacity of the lens in pseudophakic eyes

    ABSTRACT

    

    Laser posterior capsulotomy in case of the 1st degree of posterior capsular opacity of the lens in pseudophakic eyes

    

    A.D. Chuprov, M.A. Shcherbakov, L.V. Demakova

    

    1 The Kirov State Clinical Ophthalmic Hospital, Kirov;
2 The Kirov State Medical Academy, Kirov;
3 The Ophthalmic Clinic «Sozvezdye» (Constellation), Kirov

    

    Purpose. To identify indications for laser posterior capsulotomy in case of the 1st degree of posterior capsular opacity (PCO) of the lens in pseudophakic eyes.

    Material and methods. The study was carried out in 43 patients (43 eyes) aged 45-74 years old, 58% of them – female and 42% – male, with the 1st degree of posterior capsular opacity of the lens. Biomicroscopy and optical coherence tomography (OCT) were performed to evaluate changes in the posterior capsule. All patients underwent the laser posterior capsulotomy. The follow-up was 2 years.

    Results and discussion. In PCO of the 1st degree a reduction of the best corrected visual acuity (BCVA) by 2-3 lines from the initial line was revealed in all cases.

    In 35% of patients with a transparent posterior capsule according to the OCT an increase in the optical density of the posterior capsule was noted, as well as increase in the space between the posterior surface of the IOL and the posterior capsule, inclusions were different in the optical density in the pre-capsular interface. Folds of the transparent posterior capsule were detected in 25% of patients. About 5% of patients had a change of posterior capsule according to the type of a «vitreous» loose membrane. Mixed changes of posterior capsule were observed in 35% of patients.

    After the laser posterior capsulotomy the BCVA was increased up to the initial level in all patients. In the analysis of OCT images of macular retinal area before and after the laser posterior capsulotomy any reliable signs of edema were not revealed.

    Conclusions.

    1. In case of PCO of the 1st degree a reduction of the BCVA by 2-3 lines from the initial level was found.

    2. Changes in the posterior capsule of the lens of the 1st degree can be detected using the OCT despite the absence of changes in the biomicroscopy.

    3. Indications for laser posterior capsulotomy in case of the 1st degree of posterior capsule opacity of the lens are: an increased optical density of posterior capsule confirmed by the OCT data, posterior capsular thickening and folds, complaints of patients on the reduced visual acuity by 2-3 lines in the postoperative period.

    4. Complications in the form of macular edema after the laser posterior capsulotomy in case of the 1st degree of posterior capsular opacity of the lens are not revealed, that was connected with the adequate choice of laser capsulotomy technique.

    Key words: laser posterior capsulotomy, changes in the posterior capsule of the lens, pseudophakia, macular edema.