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Clinical science
Effect of Nd:YAG capsulotomy on the morphology of surviving Elschnig pearls
  1. N Hirnschall1,2,
  2. T Neumayer2,
  3. M Georgopoulos2,
  4. O Findl1,2
  1. 1
    Moorfields Eye Hospital, London, UK
  2. 2
    Department of Ophthalmology, Medical University of Vienna, Vienna, Austria
  1. Correspondence to Dr O Findl, Moorfields Eye Hospital NHS Foundation Trust, City Road, London EC1V 2PD, UK; oliver{at}


Aim: 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 min 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 turnover.

Conclusion: Capsulotomy had an 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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  • Competing interests None.

  • Ethics approval Ethics approval was provided by Ethics Committee of the Medical University of Vienna.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.