Effect of Nd:YAG capsulotomy on the morphology of surviving Elschnig pearls.

Abstract

To observe the short-term changes in morphology of Elschnig pearls induced by Nd:YAG capsulotomy. Department of Ophthalmology, Medical University of Vienna, Austria Twenty eyes of 19 pseudophakic patients with regeneratory posterior capsule opacification (PCO) that were scheduled for YAG capsulotomy were included in this prospective study. High-resolution digital retroillumination images were taken 2 weeks, 1 week and shortly before and immediately, 1 week and 2 weeks after Nd:YAG capsulotomy. The series of images were analysed using a dedicated image analysing software (PearlTracer). In total, 2431 Elschnig pearls were observed over the time-course of 4 weeks in this study. Of these, 535 pearls (30.6%) disappeared, and 503 pearls (27.6%) survived on the remaining capsule peripheral to the capsulotomy opening. The surviving pearls showed a significant decrease in size (20%) from immediately before to 10 min after capsulotomy. Within the first weeks after capsulotomy, there was a high number of newly appearing pearls, with 26% of all pearls being new between 1 and 2 weeks indicating high pearl turnover. Capsulotomy had an immediate impact on the morphology of PCO outside the capsulotomy opening, probably due to the direct mechanical impact of the laser shockwave.