Objectives: To do report the incidence of capsular changes in Crystalens-implanted eyes and analyze the indications and outcomes of yag capsulotomy. Methods: We reviewed the records of 411 eyes of 258 patients implanted with the Crystalens IOL. Capsular change indications for yag capsulotomy were posterior capsular opacification (PCO), lens tilt, and capsular striae. Eyes in each indication were further subdivided into therapeutic yag (TY) and prophylactic yag (PY) groups. Outcomes before and after yag capsulotomy were analyzed. Results: Ninety of 411 crystalens-implanted eyes (22%) had undergone yag capsulotomy. Sixty-one eyes had PCO, 12 had lens tilt, and 17 had striae. Twenty-seven eyes belonged to the therapeutic (TY) and 63 eyes to the prophylactic (PY) yag subgroups. The mean interval between phacoemulsification and yag capsulotomy was 10 months. In the TY PCO subgroup, uncorrected distance visual acuity (UDVA) changed from 20/40 pre-yag to 20/25 post-yag, uncorrected near visual acuity (UNVA) from J3 to J2, manifest refraction spherical equivalent (MRSE) from -0.43D to -0.2D. In the TY tilt subgroup, UDVA changed from 20/50 to 20/30, UNVA was unchanged at J2, and MRSE from -1.21D to -0.89D. In the TY striae group, UDVA changed from 20/50 to 20/30, UNVA from J3 to J2, and MRSE from 0.62D to -0.4D. In the PY PCO subgroup, UDVA was unchanged at 20/25, UNVA unchanged at J2, and MRSE changed from -0.52D to -0.47D. In the PY tilt subgroup, UDVA changed from 20/25 to 20/20, UNVA unchanged at J2, and MRSE changed from -0.87D to -0.45D. In the PY striae subgroup, UDVA was unchanged at 20/30, UNVA changed from J3 to J2, and MRSE changed from -0.62D to -0.7D. Conclusion Capsular changes occurred after Crystalens implantation that necessitated yag capsulotomy. Once vision has deteriorated, a therapeutic yag treatment can help improve vision. If capsular changes have occurred but vision has not deteriorated, a prophylactic yag capsulotomy can stabilize visual and refractive outcomes.
Multifocal Intraocular Lenses ; YAG capsulotomy