Influence of neodymium:YAG laser capsulotomy on ocular wavefront aberrations in pseudophakic eyes with hydrophilic and hydrophobic intraocular lenses

Purpose

To study the influence of neodymium:YAG (Nd:YAG) laser capsulotomy on ocular wavefront aberrations.

Setting

Department of Ophthalmology, Antwerp University Hospital, Edegem, Belgium.

Methods

The wavefront aberrations in pseudophakic eyes with posterior capsule opacification (PCO) were measured with an iTrace aberrometer before and after Nd:YAG laser capsulotomy. These results were analyzed using Zernike coefficients, the total and higher-order root-mean-square (RMS) values, and the wavefront peak–valley difference. In addition, a separate evaluation was performed of 2 intraocular lens (IOL) types: the hydrophilic 92S (hydrophilic IOL subgroup) and the hydrophobic AcrySof SA60AT (hydrophobic IOL subgroup).

Results

The study evaluated 62 pseudophakic eyes (56 patients). The RMS values in all eyes decreased significantly after Nd:YAG laser capsulotomy; the mean decrease in total RMS was 0.186 μm ± 0.445 (SD) and in higher-order RMS, 0.138 ± 0.223 μm. The decrease in total RMS (mean 0.325 ± 0.372 μm) was significant in the hydrophobic IOL subgroup (n = 14) but not in the hydrophilic IOL subgroup. Before capsulotomy, there was a statistically significant difference between the 2 subgroups in the higher-order astigmatism coefficient C(4,−2). After laser capsulotomy, the difference was significantly less.

Conclusion

Neodymium:YAG laser capsulotomy significantly reduced the wavefront RMS in the hydrophobic IOL subgroup but not in the hydrophilic IOL subgroup. The difference in the wavefront before capsulotomy may originate from a difference in the healing response of the capsular bag between the 2 IOL types.