Turkiye Klinikleri Journal of Ophthalmology

.: ORIGINAL RESEARCH
The Effect of Nd:YAG Laser Posterior Capsulotomy on Macular Pigment Optical Density in Cases with Posterior Capsule Opacification
Arka Kapsül Kesafeti Olan Olgularda Nd:YAG Lazer Posterior Kapsülotominin Maküla Pigmenti Optik Yoğunluğuna Etkisi
Bünyamin KUTLUKSAMANa, Mustafa DOĞANb
aKahramanmaraş Necip Fazıl City Hospital, Clinic of Ophthalmology, Kahramanmaraş, TURKEY
bAfyonkarahisar University of Health Sciences Faculty of Medicine, Department of Ophthalmology, Afyonkarahisar, TURKEY
Turkiye Klinikleri J Ophthalmol. 2020;29(3):207-17
doi: 10.5336/ophthal.2019-72054
Article Language: EN
Full Text
ABSTRACT
 Objective: To investigate the effect of ND:YAG laser capsulotomy on macular pigment optical density(MPOD) in patients with posterior capsule opacification(PCO). Material and Methods: This prospective and single-arm clinical trial included 38 participants with pseudophakic eyes. MPOD, choroidal(CT) and central macular thicknesses( CMT), as well as anterior chamber parameters, were measured before ND:YAG laser and the measurements were repeated after one week, one month and two months. The changes in the parameters and correlations were evaluated statistically. Results: There were significant decreases in the MPODs of the fovea and pericentral during the study (p<0.01 for both). The mean ICA (iridocorneal angle), ACD (anterior chamber depth) and CMT significantly increased during the study period (p<0.01). The mean CTs of the nasal and subfoveal regions also increased significantly (p<0.01). There were significant negative correlations between the changes in the mean total applied laser energy and MPODs (r>0.6, p<0.01), and there were significant and same direction relations between the changes in the mean total laser energy, and ICA, ACD, as well as CMT(r>0.6, p<0.01). Conclusion: Posterior laser capsulotomy resulted in decreases in MPODs, while there were increases in the mean ICA, ACD, CT and CMT. Laser capsulotomy can affect the posterior capsule integrity and macular pigment, therefore, it can cause more vulnerable situations in the retina against high-energy blue lights.

Keywords: Anterior chamber parameters; central macular thickness; macular pigment optical density; neodymium-doped: yttrium aluminium garnet laser; posterior capsule opacification
ÖZET
 Amaç: Arka kapsül kesafeti (AKK) tanılı hastalarda Nd:YAG lazer kapsülotominin maküla pigmenti optik yoğunluğu (MPOY) üzerine etkisinin araştırılması amaçlanmıştır. Gereç ve Yöntemler: Bu prospektif vaka kontrollü çalışmada AKK tanısı alan ve posterior lazer kapsülotomi planlanan 38 hasta çalışmaya dahil edildi. Lazer kapsülotomi uygulaması öncesi bütün katılımcıların MPOY, koroid kalınlığı (KK), iridokorneal açı (IKA), ön kamara derinliği (ÖKD), santral maküla kalınlığı (SMK) ile birlikte uygulanan lazer kapsülotomi parametreleri kaydedildi. Aynı ölçümler lazer kapsülotomi sonrası 1. hafta, 1. ay ve 2. ayda tekrar edildi ve veriler kaydedildi. Elde edilen verilerin süreç içerisindeki değişimleri ve birbirleri ile korelasyonları istatistiksel olarak değerlendirildi. Bulgular: Çalışma süresince fovea ve perisentral MPOY ortalama değerlerinde anlamlı azalma mevcuttu (p<0,01, her iki değer için). Çalışma süresince ortalama İKA, ÖKD ve SMK anlamlı olarak arttı (p<0,01). Nazal ve subfoveal bölge ortalama KK'de anlamlı olarak arttı (p<0,01). Ayrıca uygulanan toplam lazer enerjisi ile MPOY değişimi arasında anlamlı negatif korelasyon mevcut iken (r>0,6, p<0,01), uygulanan ortalama toplam lazer enerjisi ile İKA, ÖKD ve CMT değişimleri arasında anlamlı ve aynı yönde ilişki mevcuttu (r>0,6, p<0,01). Sonuç: Posterior lazer kapsülotomi MPOY'da azalamaya neden olurken, İKA, ÖKD, KK ve SMK değerlerinde artışlara neden olmuştur. Lazer kapsülotomi işlemi arka kapsül bütünlüğünü ve maküla pigmentini etkileyen bir işlem olarak yüksek enerjili mavi ışığa karşı retinada daha korumasız ve daha hassas bir duruma neden olabilir.

Anahtar Kelimeler: Ön segment parametreleri; santral maküla kalınlığı; maküla pigmenti optik yoğunluğu; neodymium-doped:yttrium aluminium garnet lazer; arka kapsül kesafeti
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