Nd:YAG Laser Capsulotomy Does Not Alter IOL’s Axial Position

Posterior capsular opacity in Pseudophakia patient.
Posterior capsular opacity in Pseudophakia patient.
Researchers utilize advanced imaging to evaluate IOL movement before and after a laser treatment.

Laser capsulotomy does not influence the axial position of a single-piece C-loop intraocular lens (IOL) inside the capsular bag, or other anterior chamber parameters, according to a study published in Clinical Ophthalmology

The success rate of capsulotomy using an Nd:YAG laser is higher than 95%, according to the report. However, the procedure is associated with numerous complications, including intraocular pressure (IOP) spikes, corneal damage, uveitis, anterior hyaloid disruption, cystoid macular edema, IOL damage, movement, or dislocation, and refractive changes. 

In a prospective study, researchers evaluated the effect of Nd:YAG laser capsulotomy on IOL position and anterior segment parameters. The investigation included 50 eyes of 50 patients (32 women, 18 men). The mean age was 71.41±15.02 years (range 23–93). All participants experienced visually significant posterior capsular opacification (PCO) following uneventful phacoemulsification surgery with manual capsulorhexis and single-piece C-loop acrylic IOL implantation and subsequently underwent Nd:YAG laser treatment. 

Investigators captured anterior segment images via an anterior segment optical coherence tomography (AS-OCT) device in non-dilated conditions, before and 1 month after the procedure. They used the “Metrics App” to collect 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). 

The researchers found no statistically significant differences between the IOL position before and after the Nd:YAG capsulotomy (3.96±0.55 vs 3.97±0.55 mm, P =.10). In 28 patients, there was a backward movement of the IOL. In the other 22 patients, the IOL moved forward or did not change at all. 

No significant alterations were observed in ACA at the 3 and 9 o’clock reference points, ACV, or CCT. After the procedure, there was an improvement in CDVA (0.37±0.21 vs 0.12±0.27 logMAR, P =.015), without statistically significant differences in SE (−0.15±0.84 vs −0.25±0.93, P =.42). Axial length was not associated with ACD variations following the procedure (P =.67).

The study authors report several limitations such as all measurements were conducted under non-dilated conditions. Additionally, PCO severity was not taken into account, and the study results are not applicable to other IOL designs. 


João MD, Costa JV, Monteiro T, Franqueira N, Faria Correia F, Vaz F. 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. Clin Ophthalmol. Published online January 18, 2022. doi:10.2147/OPTH.S349649