Introducing a modified neodymium:yttrium aluminum garnet posterior capsulotomy technique : case series study of a continuous ascending linear shot pattern

Objective: Neodymium:yttrium aluminum garnet laser capsulotomy is the gold standard treatment for posterior capsule opacification. Herein, we described a novel technique that has the potential to enhance the efficacy and safety of this procedure. Methods: The technique utilizes multiple continuous ascending linear pattern laser shots, beginning at the bottom and forming successive horizontal rows upward. This approach results in a circular capsulotomy with minimal residual cloudiness along the edge of the intraocular lens optic. Results: A total of 26 eyes from 23 patients with posterior capsule opacification were treated. The mean age of the participants was 73 ± 9.8 years. The average total energy used was 118.3 mJ. The average pretreatment best-corrected visual acuity was 0.45 ± 0.47 logMAR scale, which improved to 0.40 ± 0.53 following treatment. In 84% of cases, the optical axis was clear at the end of the intervention. Three patients reported subjective floaters, and two eyes required revision procedures. We did not observe any complications after the treatment. Conclusions: The continuous ascending linear pattern posterior capsulotomy technique offers several potential advantages, including increased efficiency with lower energy usage, a larger optical opening, fewer capsule remnants, and reduced subjective complaints. Further studies involving a larger number of cases are required to evaluate this technique thoroughly.