Neodymium-YAG laser for posterior capsulotomy.

We used the neodymium-YAG laser to perform discission of the posterior capsule in 49 eyes of 47 patients who had undergone previous extracapsular cataract extraction. The visual results were encouraging, with an improvement in visual acuity of one or more Snellen lines in 45 eyes and an improvement of three or more Snellen lines in 33 eyes. The complications included increases in intraocular pressure in 28 eyes. Intraocular pressures between 21 and 40 mm Hg were detected in 21 eyes and exceeded 41 mm Hg in another seven. In 14 of the 16 eyes in which intraocular pressure increased to more than 30 mm Hg, the maximum intraocular pressure was detectable within three hours after treatment. Other complications included damage to the intraocular lens in 12 of 30 eyes with implants and rupture of the anterior hyaloid face with forward displacement of vitreous into the anterior chamber in six of 19 eyes without implants. One of these eyes later developed a rhegmatogenous retinal detachment. A transient laser-induced hemorrhage occurred in one eye.