Korean J Ophthalmol.  2008 Sep;22(3):159-163. 10.3341/kjo.2008.22.3.159.

Neodymium YAG Laser and Surgical Synechiolysis of Iridocapsular Adhesions

• Kim EA
• Bae MC
• Cho YW

• KMID: 1070750
• DOI: http://doi.org/10.3341/kjo.2008.22.3.159

Abstract

PURPOSE: Several articles have been published on the successful elimination of iridolenticular synechiae after cataract extraction with a neodymium YAG laser (Nd:YAG laser) and surgical synechiolysis during cataract surgery, but the indications recommending which method is proper to use for specific kinds of adhesions have not yet been established. METHODS: We retrospectively reviewed the medical records of 106 patients who had undergone Nd:YAG laser or surgical synechiolysis between January 2002 and December 2007 in our clinic. Laser synechiolysis was performed in the synechiae not exceeding the extent of one clock hour and reaching only to the iris sphincter, whereas surgical synechiolysis was performed in other diffuse and/or thick synechiae. RESULTS: Surgical synechiolysis was performed in 93 eyes, and YAG laser synechiolysis was done in 21 eyes. Increases in best-corrected visual acuity (BCVA) were observed in 61 eyes (53.51%). Intraocular pressure spikes after the procedure were present in only 4 eyes, and all of them were transient except for 1 eye, which needed additional glaucoma eyedrops. CONCLUSIONS: With suitable indications, laser or surgical synechiolysis can be performed safely, and a small rise in visual acuity may also be expected.

Keyword

Iridocapsular adhesions; Nd:YAG laser; Synechiae; Synechiolysis

MeSH Terms

Adult
Aged
Aged, 80 and over
Cataract Extraction
Female
Humans
Iris Diseases/*surgery
Lasers, Solid-State/*therapeutic use
Lens Capsule, Crystalline/*surgery
Lens Diseases/*surgery
Male
Middle Aged
Postoperative Complications/*surgery
Retrospective Studies
Tissue Adhesions/surgery
Visual Acuity

Figure

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  Fig. 1 Focal and thin synechiae (A) is destructed after Nd: YAG laser synechiolysis (B). Otherwise, diffuse synechiae (C) is destructed surgically (D).

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  Fig. 2 Method of surgical synechiolysis. (A) A small paracentesis wound was made at the limbus. (B-C) An iridocapsular adhesion was broken by a synechiolysis spatula through the wound. (D) Irrigation of the anterior chamber with a balanced salt solution was done in all cases to wash out the dispersed iris pigment and any possible microhemorrhages and also to set proper intraocular pressure. (E) Pharmacologic miosis with miochol was performed as needed on a case-by-case basis to prevent re-adhesion. (F) Any leakage from the paracentesis wound was checked at the end of the procedure.

Reference

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