Assessment of Visual Acuity Following Nd:YAG Laser Posterior Capsulotomy: A Six-Month Prospective Study

Background: Posterior capsule opacification (PCO) remnants a communal difficulty following cataract surgery, significantly impacting visual outcomes worldwide. In Bangladesh, where access to innovative eye care can be stimulating, actual and safe interferences like Nd:YAG laser posterior capsulotomy are vital for renovating vision and refining quality of life for a large people affected by this condition. Aim: To evaluate the effect of Nd:YAG laser posterior capsulotomy on visual acuity over a six-month period and to explore the association between the size of the capsulotomy and visual outcomes, along with observation of any clinically evident intra- or post-operative complications. Methods: A prospective, cross-sectional study was conducted at BSMMU, Dhaka, from April 2022 to March 2023, concerning 81 pseudophakic patients with declined visual acuity due to posterior capsule opacification. Patients were nominated based on predefined inclusion and exclusion criteria, and all underwent Nd:YAG laser posterior capsulotomy executed by a single ophthalmologist using a uniform protocol. Pre-and post-procedure assessments included visual acuity, intraocular pressure, and comprehensive anterior and posterior segment checkups. Capsulotomy size was assessed using variable slit-lamp beam widths at various angles. Postoperative medications were prescribed for 15 days, and all patients were followed for six months. Statistical analysis was conducted using SPSS v26, with significance set at p <0.05. Results: A significant improvement in visual acuity was observed in both eyes following Nd:YAG laser posterior capsulotomy, sustained up to six months post-treatment (p < 0.001). The highest developments were seen with medium-sized (3 mm) capsulotomies. Visual outcomes varied significantly with capsulotomy size, mainly at one- and six-month post-procedure (p < 0.001). The procedure was well-tolerated, with minimal complications: transient intraocular pressure (IOP) rise in 2.5% and IOL pitting in 1.2% of cases. Conclusion: Nd:YAG laser posterior capsulotomy significantly and sustainably progresses visual acuity with nominal complications; 3 mm capsulotomy size confirms optimal visual gains.