Nd:YAG Laser Capsulotomy vs. Needle Aspiration in Intumescent Cataracts: A Comparative Study of Complications and Outcomes

To compare the complications and postoperative outcomes of Nd:YAG laser anterior capsulotomy vs a needle aspiration approach for capsulorhexis in patients with intumescent cataracts. University of Health Sciences, Basaksehir Cam and Sakura City Hospital Department of Ophthalmology, Istanbul, Turkey. Retrospective, cross-sectional study. Patients with intumescent cataract were divided into 2 groups. Group 1 (37 eyes) underwent Nd:YAG laser capsulotomy preoperatively, which reduced lens pressure. In Group 2 (31 eyes), the capsulorhexis was completed by reducing the intralenticular pressure by needle aspiration and then gradually expanding the capsule. Demographics, pre/postoperative parameters, complications, and surgical times were analyzed. 68 eyes of 68 patients were evaluated. Age and sex exhibited no significant differences between groups. Group 2 had more complications than Group 1 ( P = .041). Specifically, no capsular tear extensions were seen in Group 1 while 4 patients in Group 2 had tears extending to the lens periphery. Group 1 showed a significant decrease in surgical maneuvers and time ( P = .028) while no significant difference was found in effective phacoemulsification time ( P = .076). Nd:YAG laser capsulotomy effectively prevented capsular extensions and reduced surgical time in intumescent cataracts. This technique provides a safe alternative to traditional methods, potentially reducing intraoperative risks and improving surgical efficiency. The findings support Nd:YAG laser anterior capsulotomy as a viable approach for capsulorhexis in intumescent cataracts, emphasizing its potential benefits in reducing complications and enhancing surgical outcomes.