Intraocular pressure change after neodymium:YAG capsulotomy

PURPOSE: To study intraocular pressure (IOP) after neodymium:YAG (Nd:YAG) laser posterior capsulotomy in eyes that had phacoemulsification, anterior continuous curvilinear capsulotomy, in-the-bag intraocular lens (IOL) implantation, and no apparent communication between the aqueous and vitreous compartments after the Nd:YAG capsulotomy. SETTING: Northwest Kansas Eye Clinic, Hays, Kansas. METHODS: This study comprised 101 eyes. All patients received one drop of apraclonidine hydrochloride 0.5% (lopidine) 30 to 60 minutes before and then after Nd:YAG capsulotomy, intraocular pressure was measured preoperatively before administration of lopidine and at 1 to 3 and 24 hours, 1 week, and 1 month postoperatively. RESULTS: Within 24 hours after the Nd:YAG capsulotomy, no significant IOP elevations occurred. Although there was one case of modest IOP elevation at 1 week postcapsulotomy, none was seen at 4 weeks. There was no relation between change in IOP and number of laser pulses, energy per pulse, or total energy. CONCLUSION: The results indicate that lack of communication between the aqueous and vitreous compartments with an intact capsulorhexis over the lens optic rim prevented obstruction of the trabecular network by cellular debris or vitreous. This, coupled with the reduction in aqueous formation by lopidine, prevented significant IOP elevation. In patients meeting the study criteria, routine IOP measurements 1 to 3 hours and 1 day after capsulotomy may not be necessary.