Prevention of Anterior Capsule Contraction by Anterior Capsule Relaxing Incisions with Neodymium:Yttrium–Aluminum–Garnet Laser

Purpose

To examine the effect of two or three neodymium:yttrium–aluminum–garnet (Nd:YAG) laser relaxing incisions made in the anterior capsular rim on prevention of anterior capsule contraction after cataract surgery.

Design

Randomized clinical trials.

Methods

One hundred patients scheduled for bilateral cataract surgery were randomized to one of two groups: two or three relaxing incisions in the left eye and no incisions in the right eye, and relaxing incisions in the right eye and no incisions in the left eye. The anterior capsule opening area was measured using Scheimpflug photography immediately after capsulotomy and at one, three, and six months after capsulotomy, and the percentage reduction was calculated. The degree of intraocular lens (IOL) decentration and tilt and of posterior capsule opacification (PCO) also were examined.

Results

There was no significant difference in the anterior capsule opening area between fellow eyes at baseline (P ≥ .1770). In patients who underwent two incisions, no significant difference was found between fellow eyes in the opening area (P ≥ .4098) or in the percentage of reduction (P ≥ .8730) throughout follow-up. In patients who underwent three incisions, the opening area in eyes with capsulotomy was significantly greater than that in eyes without capsulotomy (P ≤ .0154), and the percentage reduction was significantly smaller in eyes with capsulotomy than in eyes without capsulotomy (P ≤ .0016). No significant differences were found in the IOL decentration and tilt, or in PCO.

Conclusions

Three relaxing incisions made in the anterior capsule decrease the anterior capsule contraction, whereas two incisions do not.