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Srpski arhiv za celokupno lekarstvo 2014 Volume 142, Issue 7-8, Pages: 468-471
https://doi.org/10.2298/SARH1408468M
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Accidental macular hole following Neodymium:YAG posterior capsulotomy

Munteanu Mihnea (University of Medicine and Pharmacy, Department of Ophthalmology, “Victor Babeş” Timisoara, Romania)
Petrović Žarko („Đorđe Joanović” General Hospital, Department of Ophthalmology, Zrenjanin)
Stanca Horia (“Carol Davila” University of Medicine and Pharmacy, Department of Ophthalmology, Bucharest, Romania)
Rosca Cosmin (“Optilens” Clinic of Ophthalmology, Cluj-Napoca, Romania)
Jianu Adelina (“Victor Babeş” University of Medicine and Pharmacy, Department of Anatomy and Embryology, Timisoara, Romania)
Boruga Ovidiu (University of Medicine and Pharmacy, Department of Ophthalmology, “Victor Babeş” Timisoara, Romania)

Introduction. Posterior capsular opacification (PCO) is the commonest complication of cataract surgery, occurring in up to one-third of patients in a period of five years. The treatment of choice is the Neodymium:YAG laser posterior capsulotomy. This treatment can be associated with several complications, some of them severe. A rare complication of this procedure is the accidental induced macular hole. Case Outline. A 54-year-old female patient was referred to our Department because of a severe loss of vision and a central scotoma at the right eye. The patient underwent a Nd:YAG posterior capsulotomy 2 days ago, for a PCO. The fundus examination at presentation revealed a round retinal defect in the macular region, a massive inferior preretinal hemorrhage and a mild vitreous hamorrhage. A 6-months follow-up of the case, including retinography and fluorescein angiography, is presented. Conclusion. Although the Nd:YAG laser capsulotomy is a safe, noninvasive, and effective outpatient procedure to improve vision hindered by PCO, it must be recognized that it carries a low but definite risk of serious complications. Physicians and patients should be aware of these rare but severe complications regarding this otherwise safe procedure. Fortunately, most of the complications related to this procedure are transient and can be managed by proper medication.

Keywords: Neodymium:YAG laser, posterior capsulotomy, macular hole