Clinical implications of energy used in Neodymium: Yttrium Aluminum Garnet posterior capsulotomy on intraocular pressure

PURPOSE: To study the trend of the rise of intraocular pressure (IOP), with the energy used during Neodymium: Yttrium Aluminum Garnet (Nd: YAG) posterior capsulotomy. METHODS: This is a prospective interventional study undertaken at a tertiary care center. The study was conducted on 221 non-glaucomatous eyes that underwent Nd: YAG posterior capsulotomy, of which 181 patients completed the study. IOP was recorded before laser and at 1, 2, 3, 4 hours, one day, one week, and one month during the post-laser period. Patients were grouped, depending on the amount of energy used, into Group 1 (≤ 40 mJ), Group 2 (40–80 mJ), and Group 3 (>80 mJ). RESULTS: Raised IOPs were noted in all the groups at various time points; however, such cases were more in Group 3 (P = <0.001). IOP was noted to peak at the fourth hour and declined to reach baseline by one week in Group 2 and by one month in Group 3. CONCLUSION: There exists a relationship between the quantum of energy used and the amount of rising of IOP following Nd: YAG laser capsulotomy. In uncomplicated cases without preexisting glaucoma, if the amount of energy for posterior capsulotomy is limited to 40 mJ, routine use of ocular hypotensive medication can be avoided.