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Purpose: To assess the degree of posterior capsular opacification (PCO) and its influence on contrast sensitivity defocus curve (CSDC) after implantation of two trifocal intraocular lenses (IOLs), Alsafit (AT) and Liberty (L), during a 12-month follow-up. A secondary aim was to evaluate the Nd:YAG capsulotomy rate in a long time., Methods: Data from 63 subjects, 34 implanted with AT and 29 with L, were retrospectively analyzed for this pilot study. In those eyes without capsulotomy during the first year (n = 58), CSDC at 3 and 12 months after surgery and PCO grading were measured, with additional answering of a visual function questionnaire (VF-14) and a question of general satisfaction. The period after surgery up to capsulotomy or last on-demand visit without Nd:YAG was recorded for survival analysis beyond the 12-month follow-up., Results: Total area under CSDC (TAUC) between 3 and 12 months decreased from 2.96 to 1.71 for AT (p < 0.05) and from 2.73 to 2.21 (p > 0.05) for L. Of eyes, 51.6, 19.3, and 29% with AT were graded as level 0, 1, and 2 of PCO, while 85.1, 11.1, and 3.7% of eyes with L were graded as level 0, 1, and 2 (p < 0.05). PCO grading was correlated with a decrease of TAUC (ρ =  - 0.27, p = 0.04). Median time to require capsulotomy was 22 months with AT and 30 months with L (p < 0.05)., Conclusions: PCO decreases CSDC in patients with trifocal lenses. Despite using the same hydrophilic material, PCO grading and Nd:YAG capsulotomy rate was higher for AT than for L., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Objectives: To investigate the relationship between optical coherence tomography (OCT) signal strength (SS) and visual acuity in patients with posterior capsule opacification (PCO) and evaluate the effect of PCO on retinal thickness measurements., Materials and Methods: Forty-one eyes of 35 patients who were diagnosed with PCO were included in the study. Patients with any anterior or posterior segment pathology other than PCO were excluded. After ophthalmologic examination, pupil dilation was induced using 0.5% tropicamide and OCT images were acquired. The assessment was repeated 1 month after Nd:YAG laser capsulotomy and postoperative values were compared with baseline values., Results: The patients’ mean best corrected visual acuity (BCVA) was 0.28±0.13 preoperatively and 0.78±0.09 postoperatively (p<0.0001). Strong positive correlations were observed between BCVA and SS both pre- and postoperatively (p<0.0001 and p=0.01, respectively). Central retinal thickness (CRT) and SS increased significantly postoperatively (p<0.0001 for both). OCT SS and CRT were strongly correlated preoperatively (p=0.001) but not postoperatively (p=0.46)., Conclusion: OCT SS correlates with visual acuity in patients with PCO, and PCO can affect the accuracy of objective data obtained with OCT.

Purpose: To compare changes in anterior segment parameters after Nd:YAG laser capsulotomy in eyes that underwent either combined phacovitrectomy or cataract surgery., Methods: This retrospective study enrolled 37 eyes of 35 patients with posterior capsular opacification treated with combined phacovitrectomy (group A), and 35 eyes of 32 patients with posterior capsular opacification treated with cataract surgery (group B). Anterior segment parameters, including anterior chamber depth (ACD), anterior chamber angle, and anterior chamber volume, were measured by a Pentacam before Nd:YAG laser capsulotomy and 1 hour, 1 day, 1 week, 1 month, and 3 months after this treatment., Results: In the cataract surgery group, the ACD was significantly lower 1 day (3.75 ± 0.74 mm), 1 week (3.73 ± 0.24 mm), and 3 months (3.74 ± 0.33 mm) after Nd:YAG laser capsulotomy compared with the pretreatment value (4.20 ± 0.62 mm, p = 0.002). By contrast, the ACD did not change significantly over time in the combined phacovitrectomy group. The ACD differed significantly between the two groups at 1 week, 1 month, and 3 months after capsulotomy. There were no significant changes in the anterior chamber volume, anterior chamber angle, central corneal thickness, or pupil size from before to after capsulotomy in either group. A non-significant trend toward myopic shift was observed in group A ( p = 0.072) and B ( p = 0.055)., Conclusions: The results of the present study may help determine the power of the intraocular lens in patients who underwent combined surgery or cataract surgery and who will receive Nd:YAG laser capsulotomy., Competing Interests: No potential conflict of interest relevant to this article was reported., (© 2018 The Korean Ophthalmological Society.)

A 77-year-old man had cataract surgery in the left eye in March 2017. A toric intraocular lens (IOL) was implanted because of astigmatism. The postoperative meridian of the IOL was located nearly exactly in the planned meridian, which was controlled 1 week later with ray-tracing aberrometry (iTrace) and the smartphone application Axis Assistant. The referring ophthalmologist proceeded directly with a neodymium:YAG (Nd:YAG) laser posterior capsulotomy in his own office, after which the meridian of the implanted toric IOL was rotated more than 115 degrees. The rotation of the IOL was likely the result of a very early Nd:YAG treatment. Therefore, when a toric IOL is implanted it is important to wait at least 3 months after cataract surgery before proceeding with Nd:YAG to ensure complete rotational stability of the IOL., (Copyright © 2018. Published by Elsevier Inc.)

Background: The aim was to investigate the effects of neodymium-doped yttrium aluminum garnet laser capsulotomy on the main numerical parameters of the anterior segment with Pentacam in patients with opacification of the posterior capsule., Methods: Thirty eyes of 30 patients (19 male, mean age 66.9 ± 8.1 years) with visually significant posterior capsular opacification were enrolled. Patients had undergone phacoemulsification surgery with three-piece intraocular lens (Sensar, AMO, USA) implantation. Full ocular examination was performed before and after capsulotomy. Intraocular pressure (Goldmann applanation tonometry) and refractive changes were measured. Pentacam measurements of the patients before and one week and one month after capsulotomy were obtained., Results: Mean visual acuity (logMAR) improved pre-operatively (0.50 ± 0.36) to one week (0.04 ± 0.07) and one month after capsulotomy (0.03 ± 0.06; p < 0.001). Mean spherical and cylindrical powers were 0.50 ± 0.98 DS and -1.61 ± 1.00 DC before the procedure and 0.10 ± 0.80 DS and -0.92 ± 0.66 DC at one month, respectively. There was a significant decrease in cylindrical errors (p = 0.001) and a myopic shift in spherical errors (p = 0.01) after the procedure. Mean anterior chamber depth (ACD) was 4.26 ± 0.63 mm before the procedure, 3.73 ± 0.56 mm at one week and 3.75 ± 0.56 mm at one month. The decrements in anterior chamber depth were significant (p < 0.001). The mean of the anterior chamber angle measurements was 43.41 ± 6.87 degrees before the procedure, increased to 45.56 ± 7.01 degrees at one week and decreased to 44.56 ± 6.13 degrees at one month. The increments in anterior chamber angle at the first week of the procedure were significant (p = 0.01). Mean central corneal thickness was 549.60 ± 41.70 μm before the procedure, increased to 551.40 ± 39.72 μm at one week and decreased to 542.30 ± 35.48 μm at one month. The decrements in central corneal thickness were significant (p = 0.048)., Conclusion: Mean anterior chamber depth decreased by approximately 0.5 mm after capsulotomy. This decrement in anterior chamber depth might be a clue for associated complications, such as unwelcome refractive errors, changes at intraocular lens position, post-procedure intraocular pressure increases and acute glaucoma., (© 2014 The Authors. Clinical and Experimental Optometry © 2014 Optometry Australia.)

Background: Posterior capsule opacification (PCO) is the most common post-operative complication associated with cataract surgery and is mostly treated with Nd:YAG laser capsulotomy. Here, we demonstrate the use of high-resolution spectral-domain optical coherence tomography (OCT) as a technique for PCO analysis. Additionally, we evaluate the influence of PCO types and the distance between the intraocular lens (IOL) and the posterior capsule (PC), i.e., the IOL/PC distance, on the total-pulse energy required for the Nd:YAG laser posterior capsulotomy., Methods: 47 eyes with PCO scheduled for the Nd:YAG procedure were examined and divided into four categories: fibrosis, pearl, mixed type and late-postoperative capsular bag distension syndrome. Using custom-made computer software for OCT image analysis, the IOL/PC distances in two dimensions were measured. The IOL/PC distances were compared with those of a control group of 15 eyes without PCO. The influence of the different PCO types and the IOL/PC distance on the total-pulse energy required for the Nd:YAG procedure was analyzed., Results: The total-pulse energy required for a laser capsulotomy differs significantly between PCO types (p = 0.005, Kruskal-Wallis test). The highest energy was required for the fibrosis PCO type, followed by mixed, pearl and late-postoperative capsular bag distension syndrome. The IOL/PC distance also significantly influenced the total-pulse energy required for laser capsulotomy (p = 0.028, linear regression). Lower total-pulse energy was expected for a larger IOL/PC distance., Conclusions: Our study indicates that the PCO types and the IOL/PC distance influence the total-pulse energy required for Nd:YAG capsulotomy. The presented OCT method has the potential to become an additional tool for PCO characterization. Our results are important for a better understanding of the photodisruptive mechanisms in Nd:YAG capsulotomy.