Intraocular pressure changes after Nd:YAG laser capsulotomy: a retrospective cohort study from ECWA Eye Hospital, Nigeria

Purpose: Nd:YAG laser capsulotomy is an effective treatment for posterior capsule opacification (PCO) but may be associated with postoperative increases in intraocular pressure (IOP), particularly in high-risk patients. This study evaluated the incidence of IOP elevation following Nd:YAG laser capsulotomy, the management strategies used, and clinical outcomes at a tertiary eye hospital in Nigeria. Methods: This retrospective cohort study included 162 patients aged 40–80 years who underwent Nd:YAG laser capsulotomy for PCO and completed at least one year of follow-up. Data on demographic characteristics, IOP measurements, visual acuity outcomes, and post-procedure management were extracted from medical records. Changes in IOP and visual acuity before and after the procedure were analyzed, and outcomes were compared between patients with and without pre-existing glaucoma. Results: Mean IOP increased significantly after the procedure (from 14.2 ± 2.1 mmHg pre-procedure to 16.7 ± 3.2 mmHg post-procedure, p6/12–6/5) increasing from 18% to 35%. Conclusions: Nd:YAG laser capsulotomy significantly improves visual acuity but may cause transient IOP elevation, particularly in patients with glaucoma. Careful postoperative monitoring and timely use of topical IOP-lowering therapy are essential to achieving favorable outcomes in resource-limited settings.