Intraocular Pressure Elevation Following Nd:YAG Laser Posterior Capsulotomy

Intraocular pressures (IOP) and tonographic outflow facilities were measured following neodymium (Nd):YAG laser posterior capsulotomy in 13 pseudophakic and 8 aphakic eyes. Mean intraocular pressure (IOP) peaked by three hours with a mean increase of 13 mmHg, remained elevated by 5 mmHg at 24 hours but returned to baseline by one week. Fourteen eyes (67%) had ≥10 mmHg elevation and eight (38%) had ≥40 mmHg maximum IOP. All the patients who eventually demonstrated a ≥10 mmHg elevation within six hours of the capsulotomy initially had an IOP elevation ≥5 mmHg at one hour. The mean outflow facility was reduced from 0.18 microl/min/mmHg before capsulotomy to 0.08 microl/min/mmHg (55%, P < 0.0001) at four hours and was still decreased at 0.13 microl/min/mmHg (27%, P < 0.05) at one week. Seventy-five percent of aphakic and 15% of pseudophakic patients had maximum IOP ≥ 40 mmHg (P < 0.01). Measurements should be performed one hour postlaser in all patients for IOP and three to four hours in aphakic patients, glaucomatous patients, patients receiving ≥200 mjoules total laser energy, and patients with ≥5 mmHg elevation at one hour in order to detect and treat significant IOP elevations.