Capsulotomy With Supine Nd:YAG Laser in Children.

OBJECTIVES

To evaluate the visual outcomes of Nd:YAG laser posterior capsulotomy performed in the supine position under general anesthesia in children with visual axis opacification after cataract surgery.

MATERIALS AND

METHODS

A retrospective clinical case series of 13 eyes of 9 children with visual axis opacification following congenital, uveitic, or juvenile cataract surgery was conducted. All patients underwent Nd:YAG laser posterior capsulotomy in the supine position under general anesthesia at the Eye Clinic, University Medical Centre Ljubljana, between September 2019 and November 2025.

RESULTS

Posterior capsulotomy was successfully performed in all 13 eyes. The median age at treatment was 9.1 years (range: 0.9-14 years) and the median follow-up was 23.8 months (range: 2-60 months). Mean best corrected visual acuity (BCVA) improved from 0.85 ± 0.60 logMAR preoperatively to 0.64 ± 0.73 logMAR postoperatively (p = 0.002). Three eyes (23%) required a secondary Nd:YAG capsulotomy due to recurrent VAO. Transient intraocular pressure elevation occurred in two eyes (15%) and resolved with topical treatment. No other complications were observed.

CONCLUSIONS

This study demonstrates the feasibility of performing Nd:YAG laser posterior capsulotomy under general anesthesia to manage VAO in children who are unable to undergo the procedure in the standard seated position.