Primary posterior laser capsulotomy (PPCL) after cataract surgery: 2-year results

Abstract Purpose: To evaluate the long-term safety and efficacy of primary posterior laser capsulotomy (PPLC) as a new method to prevent posterior capsule opacification (PCO). Setting: University Eye Hospital Bochum, Bochum, Germany. Design: Prospective randomized intraindividual comparative trial. Methods: 16 patients were examined two years after cataract surgery in both eyes. In one eye routine cataract surgery and a PPLC (PPLC group) were performed. In the other eye only routine cataract surgery (Control group) was done. For the PPLC, the posterior capsule between the anterior hyaloid surface and the optic surface of the IOL was identified with integrated 3-dimensional spectral-domain optical coherence tomography and treated with a femtosecond second laser. The main outcome measures were safety parameters such as intraocular pressure, macular thickness and volume, correct visual acuity, and the formation of PCO in both groups. Results: No significant difference was measured between the groups in intraocular pressure, endothelial cell count and macular thickness. Two eyes of the control group had Nd:YAG laser capsulotomy and were excluded from the PCO analysis. In the PPLC group the total PCO score was significant lower in comparison to the control group (0.04, SD: 0.08 to 0.26, SD: 0.31; p value 0.06). The central area of the IOL optic demonstrated no PCO in all eyes of the PPLC group. Conclusions: The formation of PCO was effectively prevented by performing PPLC; there were no long-term complications in eyes that underwent this short additional intervention.