Refractive Changes After Nd:YAG Capsulotomy in Pseudophakic Eyes

Figures & data

Table 1 Refractive Changes at One Month and One Year After Nd:YAG Capsulotomy

Follow-Up Intervals	Before Capsulotomy	After Capsulotomy	Difference	p-value
	Mean ± SD (Range)	Mean ± SD (Range)	Mean ± SD (Range)
One month, n=605
Sphere, (D)	−0.039±1.060 (−6.50 to +5.50)	−0.068±0.975 (−4.00 to +5.25)	−0.029±0.604 (−4.75 to +4.25)	0.050
Cylinder, (D)	−0.813±0.678 (−5.00 to 0.00)	−0.771±0.688 (−5.00 to 0.00)	0.042±0.448 (−2.25 to +2.00)	0.006*
SE, (D)	−0.453±1.038 (−8.25 to +5.13)	−0.473±0.941 (−5.25 to +4.88)	−0.020±0.590 (−4.75 to +4.25)	0.141
Axis, degrees	91.11±54.96 (1.00 to 180.00)	89.04±54.62 (1.00 to 180.00)	−2.066±56.53^‡ (−178.00 to +170.00)	0.803
CDVA, logMAR	0.171±0.198 (−0.13 to +1.00)	0.048±0.120 (−0.60 to +1.30)	−0.123±0.192 (−1.00 to +1.30)	<0.0001*
One year, n=211
Sphere, (D)	0.011±1.083 (−4.25 to +5.50)	0.036±1.012 (−3.00 to +6.00)	0.025±0.570 (−2.00 to +3.00)	0.851
Cylinder, (D)	−0.851±0.647 (−3.25 to 0.00)	−0.750±0.612 (−3.50 to 0.00)	0.101±0.455 (−1.00 to +2.00)	0.003*
SE, (D)	−0.415±1.059 (−4.75 to +5.13)	−0.340±1.003 (−3.25 to +5.00)	0.075±0.561 (−1.50 to +3.13)	0.271
Axis, degrees	101.90±51.91 (3.00 to 180.00)	96.73±52.19 (3.00 to 180.00)	−5.20±52.00^‡ (−171.00 to +175.00)	0.231
CDVA, logMAR	0.179±0.199 (0.00 to +1.301)	0.056±0.161 (−0.13 to +1.48)	−0.122±0.196 (−0.90 to +0.88)	<0.0001*

Notes: *Statistically significant with a p-value <0.05. ^‡Positive differences refer to counterclockwise change, negative differences refer to clockwise change.

Abbreviations: CDVA, corrected distance visual acuity; D, diopter; logMAR, logarithm of the minimum angle of resolution; Nd, neodymium; YAG, yttrium-aluminum-garnet; SD, standard deviation; SE, spherical equivalent.

Figure 1 Pre- and Postoperative Double-Angle Plots.

Abbreviation: D, diopter.

Table 2 Refractive Changes in Patients with Preoperative, One Month, and One Year Measurements

ParameterN=133	Preop Mean ± SD (Range)	One Month Postop Mean ± SD (Range)	p-value^a	One Year Postop Mean ± SD (Range)	p-value^b	Difference^c Mean ± SD (Range)	p-value^d
Sphere, D	−0.006±1.169 (−4.25 to +5.50)	0.036±1.065 (−3.00 to +5.25)	0.570	0.004±0.961 (−3.00 to +5.00)	0.731	−0.032±0.585 (−4.00 to +1.75)	0.979
Cylinder, D	−0.828±0.609 (−2.75 to 0.00)	−0.737±0.570 (−3.00 to 0.00)	0.011*	−0.735±0.557 (−3.00 to 0.00)	0.058	0.002±0.457 (−1.38 to +1.50)	0.874
SE, D	−0.427±1.140 (−4.75 to +5.13)	−0.361±1.051 (−3.75 to +4.88)	0.588	−0.364±0.970 (−3.25 to +4.63)	0.566	−0.003±0.674 (−4.00 to +2.25)	0.901
Axis, degrees	99.51±49.31 (3.00 to 180.00)	100.70±52.72 (1.00 to 180.00)	0.375	95.08±51.24 (4.00 to 180.00)	0.313	−5.66±48.20^‡ (−167.00 to +164.00)	0.572
CDVA, logMAR	0.173±0.201 (0.00 to +1.00)	0.046±0.113 (−0.12 to +0.80)	<0.0001*	0.069±0.193 (−0.13 to +1.48)	<0.0001*	0.023±0.145 (−0.18 to +1.30)	0.124

Notes: *Statistically significant with a p-value <0.05. ^‡Positive differences refer to counterclockwise change, negative differences refer to clockwise change. ^aComparing preoperative and one month measurements. ^bComparing preoperative and one year measurements. ^cDifferences between one month and one year postoperative values. ^dComparing one month and one year postoperative measurements.

Abbreviations: CDVA, corrected distance visual acuity; D, diopter; logMAR, logarithm of the minimum angle of resolution; SD, standard deviation; SE, spherical equivalent.

Figure 2 Distribution of Eyes Within Cylinder Ranges Pre- and Postoperatively.

Abbreviation: D, diopter.

Table 3 Refractive Changes with Different Lens Types

Type of Lens	Before Capsulotomy	After Capsulotomy	Difference	p-value
	Mean ± SD (Range)	Mean ± SD (Range)	Mean ± SD (Range)
Single piece, n=330
Sphere, D	0.025±0.968 (−4.25 to +3.50)	0.036±0.854 (−3.00 to +2.75)	0.011±0.528 (−1.50 to +4.25)	0.404
Cylinder, D	−0.786±0.671 (−5.00 to 0.00)	−0.774±0.689 (−5.00 to 0.00)	0.013±0.449 (−2.25 to +1.75)	0.339
SE, D	−0.368±0.925 (−4.75 to +2.38)	−0.352±0.825 (−3.75 to +2.25)	0.017±0.510 (−1.63 to +4.25)	0.543
Axis, degrees	90.97±52.10 (1.00 to 180.00)	92.56±53.18 (1.00 to 180.00)	1.59±51.00^‡ (−178.00 to +179.00)	0.337
CDVA, logMAR	0.168±0.202 (0.00 to +1.00)	0.045±0.1094 (−0.60 to +0.60)	−0.123±0.193 (−1.00 to +0.20)	<0.0001*
Three piece, n=33
Sphere, D	−0.189±1.366 (−2.75 to +5.50)	−0.174±1.282 (−2.75 to +5.25)	0.015±0.414 (−1.00 to +1.00)	0.859
Cylinder, D	−0.750±0.590 (−2.25 to 0.00)	−0.659±0.655 (−2.25 to 0.00)	0.091±0.318 (−0.50 to +0.75)	0.106
SE, D	−0.564±1.363 (−3.38 to +5.13)	−0.504±1.297 (−3.13 to +4.88)	0.061±0.419 (−0.75 to +1.00)	0.400
Axis, degrees	81.85±59.84 (3.00 to 180.00)	94.39±63.98 (2.00 to 180.00)	12.55±69.13^‡ (−178.00 to +170.00)	0.324
CDVA, logMAR	0.112±0.181 (−0.13 to +0.80)	0.049±0.154 (−0.13 to +0.80)	−0.062±0.141 (−0.48 to +0.13)	0.026*
LAL, n=16
Sphere, D	−0.672±1.052 (−2.75 to +0.75)	−0.563±0.951 (−2.75 to +0.75)	0.109±0.408 (−0.50 to +1.00)	0.301
Cylinder, D	−0.422±0.405 (−1.75 to 0.00)	−0.375±0.500 (−1.75 to 0.00)	0.047±0.306 (−0.50 to +0.50)	0.558
SE, D	−0.883±1.160 (−3.38 to +0.50)	−0.750±1.067 (−3.13 to +0.75)	0.133±0.448 (−0.75 to +1.00)	0.254
Axis, degrees	76.50±66.66 (10.00 to 180.00)	113.60±61.28 (35.00 to 180.00)	37.13±80.01^‡ (−116.00 to +170.00)	0.092
CDVA, logMAR	0.084±0.137 (−0.13 to +0.48)	0.0572±0.072 (0.00 to +0.18)	−0.027±0.131 (−0.48 to +0.13)	0.875

Notes: *Statistically significant with a p-value <0.05. ^‡Positive differences refer to counterclockwise change, negative differences refer to clockwise change.

Abbreviations: CDVA, corrected distance visual acuity; D, diopter; LAL, light adjustable lens; logMAR, logarithm of the minimum angle of resolution; SD, standard deviation; SE, spherical equivalent.

Table 4 Comparison of Prior Studies Assessing Refractive Changes After Nd:YAG Capsulotomy^†

Study	Year	Eyes, n	Interval Between Both Procedures (Months)	Latest Follow-Up Interval (Months)^a	Δ Sphere, D	Δ Cylinder, D	Δ SE, D	Δ Axis, Deg^‡	Δ CDVA, logMAR
Thornval^Citation17	1995	52	23	~1	-	-	−0.06	-	-
Hu^Citation28	2000	53	39	3	-	−0.45*	−0.06	-	-
Chua^Citation12	2001	42	24	1	-	-	0.04	-	-
Yilmaz^Citation15^a	2006	80	11.5	3	-	-	0.38^c	-	0.58*
		48					0.22^c		0.62*
Ozkurt^Citation14	2009	26	15	3			0.02		0.55*
Levy^Citation19	2009	24	>6	1	0.17	0.06			−0.36*
Vrijman^Citation18	2012	75	14	3	-	-	−0.04^b	-	−0.07*
							−0.1*^b
Karahan^Citation24^a	2014	36	32	3	-	-	0.23*	-	−0.4*
		32					0.46*		−0.5*
Oztas^Citation26	2015	30	>6	1	−0.4*	0.69*	−0.03	-	−0.47*
Khambhi-phant^Citation29	2015	47	28.3	3	-	0.02	−0.02	-	-
Cetinkaya^Citation21	2015	20	26.09	1	-	-	0	-	−0.51*
		23					0.08		−0.57*
		19					0.06		−0.49*
		23					0.05		−0.49*
Ramachand-ra^Citation16	2016	35	>6	3d	-	-	−0.21	-	−0.3*
Uzel^Citation11	2018	29	22.6	1	-	-	0.16	-	−0.34*
Monteiro^Citation22^a	2018	55	37.8	1	−0.10	−0.03	−0.12	-	-
		55	40.6		−0.11	0.25	0
Akmaz^Citation27^a	2018	35	21.2	1	−0.28*	−0.14	−0.1	-	−0.25*
		30	22.3		−0.19*	−0.01	−0.17*		−0.24*
Cao^Citation20^a	2018	20	12.42	3	-	-	−0.18	-	−0.58*
		21					−0.14		−0.42*
Parajuli^Citation13^a	2019	56	3.26	1	-	-	0.05	-	-
		40	2.46				0.02
Sirakaya^Citation25	2019	35	>6	1	-	-	0.49*	-	-
Lee^Citation23^a	2022	25	9.88	1	-	-	0.35*	-	−0.5*
		34	16.03				0.16*		−0.45*
Current Study	2022	605	47.75	1	−0.03	0.04*	−0.02	−2.1	−0.12*
		211		12	0.03	0.10*	0.08	−5.2	−0.12*

Notes: *Statistically significant change with a p-value <0.05. ^†Includes studies in which we could identify differences in pre- and postoperatively mean for at least one of the following parameters: sphere, cylinder, SE, axis. ^‡Positive differences refer to counterclockwise change, negative differences refer to clockwise change. ^aEyes were stratified, so each sample size within the study corresponds to a specific category established by the authors. ^bCalculated by subjective refraction and autorefraction, respectively. ^cP-values were not calculated.

Abbreviations: CDVA, corrected distance visual acuity; D, diopter; deg: degree; logMAR, logarithm of the minimum angle of resolution; Nd, neodymium; YAG, yttrium-aluminum-garnet; SE, spherical equivalent; Δ, change.

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