Long-Term Outcome of Nd:YAG Laser Posterior Capsulotomy in Children: Procedural Strategies and Visual Outcome

PURPOSE: To evaluate the long-term outcome of neodymium:yttrium-aluminum-garnet (Nd:YAG) laser posterior capsulotomy after cataract surgery in children. DESIGN: Retrospective case series. METHODS: Electronic medical records of pediatric patients who underwent Nd:YAG laser posterior capsulotomy between January 1, 2008, and October 31, 2012, and followed up for more than 5 years were reviewed. RESULTS: Thirty-one eyes of 25 patients were included. Only compliant patients assessed during slit lamp examination and anterior segment photography underwent laser treatment. The mean age at the time of initial laser treatment was 9.04 +/- 3.51 years (minimum 56 months), and the mean interval between cataract surgery and initial laser treatment was 28.1 +/- 22.1 months. Posterior capsular openings were successfully made in 26 (83.9%) eyes with a single attempt and in 3 (9.7%) eyes with a second attempt. Overall success rate was 93.5%. The logMAR best-corrected visual acuity was significantly improved from 0.61 +/- 0.36 to 0.19 +/- 0.25 at 1 month posttreatment (P <.0001) and well maintained, at least for 5 years of follow-up, without serious complications. The recurrence of posterior capsular opacity was observed in 7 (24.1%) eyes, which was successfully managed by repeated laser procedure or surgical capsulectomy. CONCLUSIONS: By selecting compliant patients and repeated attempts, Nd:YAG laser posterior capsulotomy can be successfully performed in a pediatric population without serious complications. Laser treatment is also a good option for managing recurred posterior capsular opacity. Restored visual acuity can be maintained for at least 5 years. (C) 2018 Elsevier Inc. All rights reserved.