Nd:YAG Laser Capsulotomy vs. Needle Aspiration in Intumescent Cataracts: A Comparative Study of Complications and Outcomes.

ABSTRACT

PURPOSE: The aim of this study is to compare the complications and postoperative outcomes of NdYAG laser anterior capsulotomy versus a needle aspiration approach for capsulorhexis in patients with intumescent cataracts. SETTING: University of Health Sciences, Basaksehir Cam and Sakura City Hospital department of Ophthalmology, Istanbul, Turkey. DESIGN: Retrospective, cross-sectional study. METHOD: Intumescent cataract patients were divided into two groups. Group 1 (37 eyes) underwent NdYAG Laser capsulotomy pre-surgery, which reduced lens pressure. In group 2 (31 eyes), the capsulorhexis was completed by reducing the intralenticular pressure by needle aspiration and then gradually expanding the capsule. Demographics, pre/post-op parameters, complications, and surgical times were analyzed. RESULTS: Evaluated were 68 eyes from 68 patients. Age and gender exhibited no significant differences between groups. Group 2 had more complications than Group 1 (p=0.041). Specifically, no capsular tear extensions were seen in Group 1, while four patients in Group 2 had tears extending to the lens periphery. Group 1 showed a significant decrease in surgical maneuvers and time (p=0.028), while no significant difference was found in effective phacoemulsification time (p=0.076). CONCLUSION: Nd YAG laser capsulotomy effectively prevented capsular extensions and reduced surgical time in intumescent cataracts. This technique provides a safe alternative to traditional methods, potentially reducing intraoperative risks and improving surgical efficiency. The findings support Nd YAG laser anterior capsulotomy as a viable approach for capsulorhexis in intumescent cataracts, emphasizing its potential benefits in reducing complications and enhancing surgical outcomes.