Glare and contrast sensitivity before and after Nd:YAG laser capsulotomy

The benefits of Nd:YAG laser capsulotomy on visual performance were evaluated in 13 patients with after-cataract following extracapsular cataract extraction. Besides clinical evaluation we measured: visual acuity, letter contrast sensitivity with and without the presence of a circular glare source (glare angle: 8 degrees). Finally, the patients were asked to evaluate their subjective glare problems. In all patients, visual acuity had decreased markedly compared to measurements 2 months after cataract surgery. Before capsulotomy we observed impaired letter contrast sensitivity and increased intraocular light scatter compared to normals. Following capsulotomy, VA and contrast sensitivity both improved by a factor of 2. The subjective glare problems diminished, although most patients showed minor decreases in intraocular light scatter. The limited glare induced loss of letter contrast sensitivity, present before capsulotomy, remained after treatment. Our study indicates that after-cataract impairs resolution and contrast sensitivity without necessarily causing a marked increase in light scatter as measured at a large angle.