EFFECTIVE STRATEGIES FOR PREVENTION OF COMPLICATIONS AFTER ND: YAG-LASER CAPSULOTOMY OF SECONDARY CATARACT (LITERATURE REVIEW)

Аннотация

The aim of the review was to systematize the current data on the medical management of patients after Nd:YAG laser capsulotomy for secondary cataract and to identify optimal strategies for the prevention of complications. A literature search was conducted in PubMed, Scopus, and CyberLeninka databases for 2014-2024 using the keywords "Nd:YAG capsulotomy," "secondary cataract," "intraocular pressure spike," "cystoid macular edema," and "anti-inflammatory therapy." Thirty- four studies meeting the selection criteria were included in the analysis. The results indicate that the combined use of hypotensive agents (β-blockers, carboanhydrase inhibitors, rock inhibitors) and prolonged anti-inflammatory therapy (topical GCS ± NSAIDs) reduces the incidence of intraocular pressure spike by more than 70% and reduces the risk of cystoid macular edema development to 1-2%. Low-energy laser mode (≤35 μJ, ≤25 pulses) additionally reduces the probability of damage to IOL and vitreomacular structures. Individualization of treatment taking into account biometric parameters of the eye, total laser energy and risk factors (myopia, pseudoexfoliation, early macular changes) provides the best functional outcomes and forms the prerequisites for standardization of clinical recommendations.