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Effect of Nd: YAG capsulotomy on the morphology of surviving Elschnig pearls
  1. Nino Hirnschall1,
  2. Thomas Neumayer2,
  3. Michael Georgopoulos2,
  4. Oliver Findl1,*
  1. 1 Moorfields Eye Hospital, London and Dept. of Ophthalmology, Medical University of Vienna, Vienna, United Kingdom;
  2. 2 Dept. of Ophthalmology, Medical University of Vienna, Vienna, Austria
  1. To whom correspondence should be addressed. E-mail: oliver{at}


Purpose: To observe the short-term changes in morphology of Elschnig-pearls induced by Nd:YAG-capsulotomy. Setting: Department of Ophthalmology, Medical University of Vienna, Austria

Method: Twenty eyes of 19 pseudophakic patients with regeneratory posterior capsule opacification (PCO) that were scheduled for YAG-capsulotomy were included in this prospective study. High resolution digital retroillumination images were taken 2 weeks, 1 week and shortly before and immediately, 1 week and 2 weeks after Nd:YAG-capsulotomy. The series of images were analysed using a dedicated image analysing software (PearlTracer).

Results: In total 2431 Elschnig-pearls were observed over the time-course of 4 weeks in this study. Of these 535 pearls (30.6%) disappeared and 503 pearls (27.6%) survived on the remaining capsule peripheral to the capsulotomy-opening. The surviving pearls showed a significant decrease in size (20%) from immediately before to 10 minutes after capsulotomy. Within the first weeks after capsulotomy there was a high number of newly appearing pearls, with 26% of all pearls being new between 1 and 2 weeks indicating high pearl turn over.

Conclusion: Capsulotomy had immediate impact on the morphology of PCO outside the capsulotomy opening, probably due to the direct mechanical impact of the laser shockwave.

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