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Neodymium YAG Laser and Surgical Synechiolysis of Iridocapsular Adhesions

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Porpose: Several articles have been published on the successful elimination of iridolenticular synechiae after cataract extraction with a neodymium YAG laser (Nd:YAG laser) and surgical synechiolysis during cataract surgery, but the indications recommending which method is proper to use for specific kinds of adhesions have not yet been established. Methods: We retrospectively reviewed the medical records of 106 patients who had undergone Nd:YAG laser or surgical synechiolysis between January 2002 and December 2007 in our clinic. Laser synechiolysis was performed in the synechiae not exceeding the extent of one clock hour and reaching only to the iris sphincter, whereas surgical synechiolysis was performed in other diffuse and/or thick synechiae. Results: Surgical synechiolysis was performed in 93 eyes, and YAG laser synechiolysis was done in 21 eyes. Increases in best-corrected visual acuity (BCVA) were observed in 61 eyes (53.51%). Intraocular pressure spikes after the procedure were present in only 4 eyes, and all of them were transient except for 1 eye, which needed additional glaucoma eyedrops. Conclusions: With suitable indications, laser or surgical synechiolysis can be performed safely, and a small rise in visual acuity may also be expected.

Abstract

Porpose: Several articles have been published on the successful elimination of iridolenticular synechiae after cataract extraction with a neodymium YAG laser (Nd:YAG laser) and surgical synechiolysis during cataract surgery, but the indications recommending which method is proper to use for specific kinds of adhesions have not yet been established. Methods: We retrospectively reviewed the medical records of 106 patients who had undergone Nd:YAG laser or surgical synechiolysis between January 2002 and December 2007 in our clinic. Laser synechiolysis was performed in the synechiae not exceeding the extent of one clock hour and reaching only to the iris sphincter, whereas surgical synechiolysis was performed in other diffuse and/or thick synechiae. Results: Surgical synechiolysis was performed in 93 eyes, and YAG laser synechiolysis was done in 21 eyes. Increases in best-corrected visual acuity (BCVA) were observed in 61 eyes (53.51%). Intraocular pressure spikes after the procedure were present in only 4 eyes, and all of them were transient except for 1 eye, which needed additional glaucoma eyedrops. Conclusions: With suitable indications, laser or surgical synechiolysis can be performed safely, and a small rise in visual acuity may also be expected.

참고문헌 (8)

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  2. Fankhauser F, "Neodymium Q-switched YAG laser lysis of iris lens synechiae", Ophthalmology, 92, pp.790~2 (1985)
  3. Kumar H, "Neodymium: YAG laser iridolenticular synechiolysis in uveitis", Ophthalmic Surg, 25, pp.288~91 (1994)
  4. Geerling G, "Initial clinical experience with the picosecond Nd:YLF laser for intraocular therapeutic applications", Br J Ophthalmol, 82, pp.504~9 (1998)
  5. Ganesh SK, "Cataract surgery in patients with Vogt-Koyanagi-Harada syndrome", J Cataract Refract Surg, 30, pp.95~100 (2004)
  6. Daus W, "Results of extracapsular cataract extraction with intraocular lens implantation in eyes with uveitis and Fuchs' heterochromic iridocyclitis", Ger J Ophthalmol, 1, pp.399~402 (1992)
  7. Geerards AJ, "Pupillary membrane after cataract extraction with posterior chamber lens in glaucoma patients", Doc Ophthalmol, 75, pp.233~7 (1990)
  8. Steinert RF, "Cataract surgery, 2nd", pp.552~ (2004), Pennsylvania: Saunders

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