Optical Aberrations in Pseudophakic Eyes After 2.5-mm Nd:YAG Laser Capsulotomy for Posterior Capsule Opacification

Purpose To evaluate aberrometric outcomes in eyes with posterior capsule opacification after 2.5-mm Nd: YAG laser capsulotomy compared to pseudophakic eyes without posterior capsule opacification. Methods Photographic image analysis of posterior capsule opacification was performed on 36 eyes that showed advanced posterior capsule opacification (case group) and on 36 eyes which showed absence of posterior capsule opacification (control group). Best spectacle-corrected visual acuity (BSCVA) and wavefront analysis were performed in the control group and in the case group after 2.5-mm capsulotomy. Results Mean BSCVA in the case group after treatment was significantly higher than before treatment ( P <.05) and similar to the BSCVA in the control group ( P >.1). Aberrometric analysis was performed on the control group, but light scattering prevented the analysis in posterior capsule opacification before capsulotomy, which was then performed after the intervention in 18 (50%) eyes. Mean total high order aberrations and 3rd order aberrations were significantly higher in the case group than in the control group ( P <.05). Fourth and 5th order aberration values were similar between the case and control groups ( P >.06). Conclusions Our wavefront results can detect a deterioration of visual quality in patients that underwent a 2.5-mm Nd:YAG capsulotomy compared to pseudophakic patients not affected by posterior capsule opacification. This difference cannot be detected by standard visual acuity examination. Further study is needed to clarify whether our high order aberration findings were related to small, 2.5-mm capsulotomies and whether aberrometry may be indicative for mild to moderate posterior capsule opacification. [ J Refract Surg. 2008;24:702–706.]