Gradual intraocular pressure (IOP) elevation with a need for additional treatment is common in pseudophakic glaucoma patients following Nd; YAG laser posterior capsulotomy

The Science behind the Tip

Nd: YAG laser capsulotomy is known to increase the IOP in some normal patients in the short term, with the maximum IOP elevation occurring within the first two days. This is more likely to occur in patients with glaucoma (1). The cause is reduced outflow facility and is directly related to the total laser energy delivered (2).

A delayed rise in IOP has been reported in up to 50% of patients with glaucoma two years after undergoing the procedure (3,4). The exact cause is unclear. Close monitoring of the IOP is needed for at least two years post laser treatment, after which the IOP tends to stabilise (4).

Contributor: J F Salmon MD Consultant Ophthalmologist - Oxford Eye Hospital (UK)

References:

1. Steinert RF, Puliafito CA, Kumar SR et al. Cystoid macular edema, retinal detachment and glaucoma after Nd: YAG laser posterior capsulotomy. Am J Ophthalmol 1991; 112: 373-80 2) Wetzel DW. Ocular aqueous humor dynamics after photodisruptive laser surgery procedures. Ophthalmic Surg 1994; 25: 298-302. 3) Barnes EA, Murdoch IE, Subramaniam S et al. Neodymium: yttrium - aluminum - garnet capsulotomy and intraocular pressure in pseudophakic patients with glaucoma. Ophthalmology 2004; 11: 1393-7 4) Lin J-C, Katz LJ, Spaeth GL, Kranchik JM. Intraocular pressure control after Nd: YAG laser posterior capsulotomy in eyes with glaucoma. Br J Ophthalmol 2008; 92: 337-9.

Tip Reviewer: Roger Hitchings
Tip Editors: John Salmon and Gordana Sunaric Mégevand