YAG Laser Capsulotomy Linked to Higher Risk of Diabetic Retinopathy Progression, suggests study
A recent study published in the Journal of Cataract & Refractive Surgery found that Yttrium Aluminum Garnet (YAG) laser capsulotomy, commonly performed after cataract surgery to clear posterior capsule opacification, may increase the risk of worsening diabetic retinopathy in patients with diabetes. Researchers observed that patients with nonproliferative diabetic retinopathy who underwent YAG laser treatment had a notably higher likelihood of progressing to proliferative stages and developing vision-threatening complications.
Patients aged ≥18 years with type 1 or 2 diabetes and NPDR who underwent cataract surgery with or without subsequent YAG laser capsulotomy were identified. Patients were followed for 1 year post-cataract surgery. Exclusion criteria included less than 6 months of follow-up. Primary outcomes included development of proliferative DR (PDR), vitreous hemorrhage (VH), tractional retinal detachment (TRD), neovascular glaucoma (NVG), and need for panretinal photocoagulation (PRP) or pars plana vitrectomy (PPV). The study highlighted that YAG laser capsulotomy, while generally considered a safe and routine post-cataract procedure, could potentially alter intraocular conditions that exacerbate retinal vascular stress in diabetic eyes. These changes may accelerate disease progression by influencing inflammatory and oxidative pathways. The authors suggested that careful patient selection, preoperative retinal evaluation, and close follow-up after laser treatment are crucial to minimize risks in individuals with diabetic eye disease.
The researchers concluded that ophthalmologists should weigh the benefits of improved visual clarity against the potential for retinopathy progression when considering YAG laser capsulotomy in diabetic patients. They also emphasized the need for further long-term, controlled studies to clarify the mechanism and magnitude of this risk. Early identification of high-risk patients and timely intervention could help prevent vision loss and optimize long-term outcomes.
Keywords:
YAG laser capsulotomy, diabetic retinopathy, cataract surgery, proliferative retinopathy, vision complications, Journal of Cataract & Refractive Surgery
