Selecta
PBL200051, Rev J
108 Professional Use Instructions
condition may require treatment or may interfere with, or be aggravated by,
continuation of the Nd:YAG procedure.
Pupillary block
Extra-capsular cataract extraction (ECCE) patients who did not have a
concurrent iridectomy are at increased risk of pupillary block. Although the
incidence is low, the patients should be advised that if symptoms of pupillary
block occur (such as pain), they should immediately contact the treating
surgeon.
Rupture of the anterior hyaloid face
A proportion of subjects (about 25% in clinical studies) may experience
rupture of the anterior hyaloid face. This potential is greater for aphakic
subjects (no IOL present). Such patients are at increased risk of anterior
vitreous movement from the normal plane. In the event of vitreous movement
to the cornea, an increased incidence of corneal edema may result.
Focusing of the laser is recommended, posterior to the target treatment plane
(particularly in pseudophakic subjects), then moved anteriorly as required. In
aphakic subjects, the alternative technique of focusing anterior to the target
treatment plane and moving posteriorly can be used.
Retinal damage
Retinal damage, such as retinal detachment, tears, holes, and cystoid macular
edema, has been reported in several clinical studies. The incidence of such
retinal problems remains low. Clinical estimates of these problems indicate an
incidence of less than 2%.
Patients at risk
The following patients are at special risk when undergoing Nd:YAG posterior
capsulotomy or pupillary membranectomy:
• extra-capsular cataract extraction patients without a patent
iridectomy are at an increased risk of pupillary block
• aphakic patients are at increased risk of immediate postoperative
IOP elevation
• patients with preoperative glaucoma, prior filtering surgery or
preoperative IOP of greater than 20 mm Hg, or other evidence of
deranged aqueous dynamics or poor facility outflow, are at a
significantly higher risk of postoperative IOP rise to levels of
clinical concern
• patients with IOLs, particularly posterior chamber lenses close to
the posterior capsule, are at risk of IOL pitting or cracking
• patients with pre-existing ocular conditions have a greater chance
of experiencing postoperative complications
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