Effect of diabetes on visual outcome and IOP change, treated with ND: Yag laser capsulotom
Dr. Pawan N Jarwal, Dr. Rekha Singh
Posterior capsular opacification is the most common long term complication of modern IOL surgery. Nd: YAG laser remains the cornerstone of its treatment. In this study, an attempt was made to study the visual outcome and change in the intraocular pressure following Nd: YAG laser capsulotomy and compare the results between diabetic patients and non-diabetic patients. Methods: This is a prospective study of 100 patients (50 diabetics and 50 non-diabetics), conducted in Govt. R.D.B.P. Jaipuriya Hospital, attached to R.U.H.S.-CMS Medical College, Jaipur. All patients aged 40 years and above, attending the regular OPD who presented with visually significant posterior capsular opacification were treated with Nd: YAG laser capsulotomy. Patients were followed up on first week and the first month and the improvement in the BCVA and the change in IOP was recorded. Results: All the patients treated for PCO with Nd: YAG laser capsulotomy showed an improvement in visual acuity. The visual outcome at first month (46% had > 6/12) was found to be better than that at first week (only 3% had the same).The final visual outcome at one month was found to be better in non-diabetics (62% had > 6/12) compared to diabetics (30% had > 6/12). All the patients showed an increase in IOP at the first week of follow up and return to near normal of baseline values at first month of follow up, the pattern of change in IOP being similar in both the study groups. Conclusion: Nd: YAG laser capsulotomy effectively improves the visual acuity in patients with visually significant PCO. The comparatively poor outcome in the diabetic group can be attributed to the associated retinopathy changes. Nd: YAG laser capsulotomy is associated with a transient rise in the intraocular pressure in all patients which can very rarely remain persistently high.