We performed applanation tonometry preoperatively, hourly for the first four postoperative hours and on the first postoperative day in 66 eyes after Nd:YAG laser posterior capsulotomy in order to determine the nature of the acute intraocular pressure (IOP) elevation and the risk factors involved. Forty-one percent of eyes developed an intraocular pressure greater than 30 mmHg and 14% greater than 40 mmHg. The IOP spike occurred on the second postoperative hour in 35% of eyes. Patients with controlled glaucoma prior to capsulotomy had a significantly lower mean IOP rise than patients without glaucoma. Eyes with posterior chamber IOLs were less likely to develop an IOP greater than 30 mmHg than were aphakic eyes without IOLs. There was no correlation between the laser energy or the size of the capsulotomy and the IOP rise.
"This is usually treated by Nd:YAG laser capsulotomy. However, some complications of this method have been reported, e.g. an increase of intraocular pressure (Ruderman et al., 1983; Slomovic & Parrish, 1985). Other complications such as retinal detachment (Powell & Oslon, 1995; Steinert et al., 1991), uveoscleritis (Herbort, 1994), or ciliochoroidal effusion (Schaeffer et al., 1989) were reported rarely. "
[Show abstract][Hide abstract] ABSTRACT: In a patient with uveitis who had been treated with Nd:YAG laser capsulotomy after cataract surgery, several episodes of acute hypotonia occurred which were associated with changes in clinical tests of the eye and of visual function. Immunosuppressive and immunomodulating treatment appeared to reverse the changes in intraocular pressure and normalise the test results. The significance of these observations is discussed.
Vision Research 11/1997; 37(20):2937-42. DOI:10.1016/S0042-6989(97)00085-0 · 1.82 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The creation of a posterior capsulotomy utilizing a neodymium:YAG (Nd:YAG) laser is often followed by an increase in the intraocular pressure (IOP). In order to study the cause of this pressure rise, six eyes of three cynomolgus monkeys underwent extracapsular cataract extraction followed 2 to 3 months later by Nd:YAG laser capsulotomy. Eyes were evaluated clinically and examined histopathologically at 1 hour, 3 hours, 1 day, 3 days, 1 week, and 1 month after laser treatment. Although IOP did not increase after laser capsulotomy, outflow facility was decreased 80% from baseline levels at 3 hours, at 3 hours, 1 day, and 3 days. After laser treatment, the anterior chamber and meshwork contained fibrin, lens material, inflammatory cells, pigmented macrophages, erythrocytes, and free pigment. Most of these elements had cleared the meshwork by 1 month.
[Show abstract][Hide abstract] ABSTRACT: Apraclonidine (para-aminoclonidine) is an alpha agonist that was studied for its effect on the IOP rise following YPC. In a prospective multicentered double-masked study 63 eyes were pretreated with one drop of either 1% apraclonidine or placebo 1 hour prior to performing YAG and again after the laser treatment. The greatest IOP rise in the placebo-treated eyes occurred in the third hour after YPC when the mean IOP rose from a baseline pressure of 16.4 +/- 3.7 mm Hg to 20.8 +/- 6.8 mm Hg (P less than .01). In apraclonidine-treated eyes the IOP fell from a mean of 15.6 +/- 3.8 mm Hg to 12.8 +/- 6.0 mm Hg 3 hours postoperatively (P less than .001). There were five times as many eyes that had a pressure rise greater than 10 mm Hg in the placebo-treated group compared to those treated with apraclonidine. Apraclonidine proved to be highly effective in preventing the rise in IOP following YPC.
Transactions of the American Ophthalmological Society 02/1988; 86:461-72.
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