Long-term effect of Nd:YAG laser posterior capsulotomy on intraocular pressure

Objective: To study the long-term effect of Nd:YAG capsulotomy on intraocular pressure (IOP). Methods: We reviewed the records of patients with bilateral pseudophakia who received Nd:YAG capsulotomy in only 1 eye. Using the Wilcoxon rank sum test, we compared the mean change in IOP in eyes before and after capsulotomy with that of the noncapsulotomy eyes at corresponding time intervals. Using multiple regression tests, we analyzed the factors significantly associated with postcapsulotomy long-term IOP increases. Results: The study included 100 patients who were followed up for a median of 1.5 years after capsulotomy. The mean +/- SD age of the study group was 76 +/- 7 years, and 37 patients had glaucoma. The changes in IOP in the eyes treated with capsulotomy were significantly higher than those in noncapsulotomy eyes at each time interval following capsulotomy. The long-term IOP increase was significantly associated with the IOP increase measured 1 hour after the capsulotomy (P = .001). Patients with glaucoma were more likely to require long-term additional glaucoma medication than were nonglaucoma patients to require initial glaucoma therapy after the capsulotomy (P = .002). Conclusion: After Nd:YAG capsulotomy, long-term IOP is often elevated above precapsulotomy baselines, especially in glaucoma patients or patients who experience a significant IOP increase within hours after the capsulotomy.