ABSTRACT
Purpose: Optic coherence tomography (OCT) evaluation of the choroid, retina, and retinal nerve fiber layer after uncomplicated yttrium-aluminum-garnet (YAG) laser capsulotomy. Methods: OCT analysis of retinal and choroidal structures was performed in 28 eyes of 28 patients following routine examinations before and 24 h, 72 h, 2 weeks, 4 weeks, and 12 weeks after YAG laser capsulotomy. Data were analyzed using the SPSS software. Results: Data collected before YAG capsulotomy and at the above mentioned follow-up visits are summarized as follows. Mean central subfoveal choroidal thickness before YAG capsulotomy was 275.85 ± 74.78 µm; it was 278.46 ± 83.46 µm, 283.39 ± 82.84 µm, 280.00 ± 77.16 µm, 278.37 ± 76.95 µm, and 278.67 ± 76.20 µm after YAG capsulotomy, respectively. Central macular thickness was 272.14 ± 25.76 µm before YAG capsulotomy; it was 266.53 ± 26.47 µm, 269.14 ± 27.20 µm, 272.17 ± 26.97 µm, 270.91 ± 26.79 µm, and 273 ± 26.63 µm after YAG capsulotomy, respectively. Mean retinal nerve fiber layer thickness before YAG was 99.89 ± 7.61 µm; it was 98.50 ± 8.62 µm, 98.14 ± 8.69 µm, 99.60 ± 8.39 µm, 99.60 ± 8.39 µm, and 99.60 ± 8.35 µm after YAG capsulotomy, respectively. No observed change was statistically significant. No significant changes were observed with regard to mean intraocular pressure. Conclusions: After YAG laser capsulotomy, no statistically significant changes were found in choroidal, retinal, and optical nerve fiber layer thicknesses, although slight thickness changes in these structures were observed, particularly during the first days.
Keywords:
Choroid; Retina; Tomography, optical coherence; Posterior capsulotomy/methods
RESUMO
Objetivo: Avaliação da coroide, retina e a camada de fibras nervosas da retina por meio de tomografia de coerência óptica (OCT) após capsulotomia por YAG laser não complicada. Método: Vinte e oito olhos de 28 pacientes foram incluídos neste estudo. Estruturas da retina e coroide foram analisados usando ACT nos exames de rotina antes da capsulotomia posterior por YAG laser e 24 horas, 72 horas, 2 semanas, 4 semanas e 12 semanas após YAG. Os resultados foram avaliados através do programa SPSS. Resultados: Os resultados deste estudo, pré YAG e às visitas de acompanhamento acima, podem ser resumidos da seguinte forma. A espessura média de coroide subfoveal central antes do YAG foi 275,85 ± 74,78 m; após YAG foi 278,46 ± 83,46 µm, 283,39 ± 82,84 µm, 280,00 ± 77,16 µm, 278,37 ± 76,95 µm, e 278,67 ± 76,20 µm, respectivamente. A espessura macular central foi 272,14 ± 25,76 mm antes YAG; e 266,53 ± 26,47 µm, 269,14 ± 27,20 µm, 272,17 ± 26,97 µm, 270,91 ± 26,79 µm, e 273 ± 26,63 µm, respectivamente. Espessura média da camada de fibras nervosas da retina antes do YAG foi 99,89 ± 7,61 mm; e 98,50 ± 8,62 µm, 98,14 ± 8,69 µm, 99,60 ± 8,39 µm, de 99,60 ± 8,39 µm, 99,60 ± 8,35 µm, respectivamente. Nenhuma das alterações observadas foram estatisticamente significativas. As médias da pressão intraocular, também não mostraram alterações significativas. Conclusões: Não houve mudanças significativas foram encontradas na coroide, camada de fibras nervosas da retina espessuras e ópticos, após a capsulotomia por YAG laser, embora houvesse, especialmente nos primeiros dias, discretas alterações de espessura nas estruturas mencionadas.
Descritores:
Coroide; Retina; Tomografia de coerência óptica; Capsulotomia posterior/métodos
INTRODUCTION
Despite changes in lens design and advances in surgical techniques, the development of posterior capsular opacification (PCO) is the most common complication following cataract surgery. Although various methods to treat PCO have been attempted, neodymium yttrium-aluminum-garnet (YAG) capsulotomy is yet the gold standard because it is non-invasive, can be applied rapidly under polyclinic conditions, and has a high success rate. However, some complications may occur after YAG capsulotomy(1-3).
Changes in intraocular pressure are frequently observed following YAG capsulotomy(4) and may have an impact on the choroid, which is sensitive to fluctuations inintraocular pressure (IOP). Furthermore, the probability of a reaction in the retina and choroid structures induced by the inflammation that may occur in the first days of the procedure should be considered. Moreover, retinal complications that may emerge later affect the choroid tissue. Various studies associated with anterior chamber and retinal changes in patients who have undergone YAG capsulotomy have been published(4-6). However, to the best of our knowledge, there are no publications regarding choroidal change.
Therefore, we aimed to evaluate retinal and choroidal structures within the time periods when such changes are frequently observed. Potential positive findings could indicate whether optic coherence tomography (OCT) can be used for follow-up. We aimed to identify whether there were any changes at the 72-h follow-up, when inflammation after the procedure is high,and at 8-12 weeks after the procedure, when cystoid macular edema (CME) development is expected.
METHODS
This prospective study was performed at the Ophthalmology Department of the Kayseri Education and Research Hospital. The study adhered to the tenets of the Declaration of Helsinki and was approved by the Local Ethics Committee of Erciyes University. All individuals received both oral and written information regarding the study, and each subject provided written and informed consent before participation in the study.
Patients were selected between December 2014 - March 2015, and the study involved 28 eyes of 28 patients suffering from PCO. The patients had to fulfill the following inclusion criteria: underwent cataract surgery with phacoemulsification and clinically observable PCO as observed by the slit lamp examination in only one eye; capable of being evaluated for at least 3 months after intervention by capsulotomy; and exhibited a centered intra ocular lens (IOL) with complete overlap between the anterior capsule and IOL. Patients who had glaucoma, corneal or retinal disease, uveitis, previous laser treatments, ocular trauma, or surgery during the follow-up period were excluded.
All individuals underwent a screening process involving a complete ophthalmologic examination, including refraction and visual acuity, slit-lamp biomicroscopy, intraocular pressure measured using non-contact tonometry, and fundus examination. Data on retinal nerve fiber layer (RNFL) thickness, macular thickness, macular volume, and choroidal thickness were obtained using the Spectralis OCT (Heidelberg Engineering, Heidelberg, Germany).
Image acquisition: The procedure for obtaining enhanced depth imaging (EDI)-OCT has previously been described(
