Evaluation of Changes in Central Macular Thickness After Neodymium-Doped Yttrium Aluminum Garnet (Nd:YAG) Posterior Capsulotomy: An Optical Coherence Tomography-Based Prospective Observational Study

Himanshu Singh; Rituka Gupta; Deepanshi Agrawal; Khushali Solanki; Anagha Chauhan; Khalid Khan; Priyanka

doi:10.7759/cureus.104377

Evaluation of Changes in Central Macular Thickness After Neodymium-Doped Yttrium Aluminum Garnet (Nd:YAG) Posterior Capsulotomy: An Optical Coherence Tomography-Based Prospective Observational Study

Cureus. 2026 Feb 27;18(2):e104377. doi: 10.7759/cureus.104377. eCollection 2026 Feb.

Authors

Himanshu Singh¹, Rituka Gupta², Deepanshi Agrawal³, Khushali Solanki⁴, Anagha Chauhan³, Khalid Khan³, Priyanka⁵

Affiliations

¹ Ophthalmology, Government Medical College Singrauli, Singrauli, IND.
² Ophthalmology, Lakshmi Narain College of Technology, Indore, IND.
³ Ophthalmology, Chirayu Medical College and Hospital, Bhopal, IND.
⁴ Community Medicine, Government Medical College Singrauli, Singrauli, IND.
⁵ Ophthalmology, All India Institute of Medical Sciences, Bhopal, Bhopal, IND.

Abstract

Background After cataract surgery, one of the most common complications causing diminution of vision is posterior capsular opacification (PCO). Neodymium-doped yttrium aluminum garnet (Nd:YAG) laser therapy is currently the most popular option for treating PCO, as it is a fast, non-invasive, and successful procedure. Methodology This prospective observational study was conducted at a tertiary eye care center in central India. A total of 64 pseudophakic patients were included. Preoperative evaluation included a detailed demographic history and complete ophthalmological examination, including visual acuity, intraocular pressure (IOP), and central macular thickness (CMT). All patients underwent Nd:YAG laser capsulotomy for PCO. Following laser treatment, IOP, best-corrected visual acuity (BCVA), and CMT were evaluated after three and eight weeks. Optical coherence tomography (OCT) was used to measure CMT. The data analysis was done using suitable statistical tests. Results A total of 64 patients who met the inclusion criteria were enrolled. There was a significant and stable improvement in BCVA, with mean BCVA improving from baseline 0.82 ± 0.15 logMAR preoperatively to 0.12 ± 0.09 logMAR postoperatively (p < 0.001). Regarding CMT values, post-laser macular thickness at three weeks (mean ± SD = 241.50 ± 10.76) was significantly increased (p < 0.001) compared to pre-laser macular thickness (mean ± SD = 222.89 ± 9.23); however, it was statistically non-significant at eight weeks (p = 0.08). Most patients remained within the 10-16 mmHg IOP range throughout the follow-up period. Conclusions Nd:YAG laser posterior capsulotomy is a quick, safe, and non-invasive procedure for PCO. Increased macular thickness was reported as a complication after performing YAG laser posterior capsulotomy, lasting for a substantial period, which was revealed on follow-up with OCT. As this was not clinically observed, it did not necessitate regular prophylactic treatment.

Keywords: best-corrected visual acuity (bcva); central macular thickness; nd:yag laser; optical coherence tomography; posterior capsule opacification.