Incidence, causes, and neodymium:YAG laser treatment of pupillary capture

Objective: To report the incidence of and factors associated with pupillary capture after cataract surgery and evaluate the outcomes of treatment with the neodymium:YAG (Nd:YAG) laser. Setting: Unit of Ophthalmology, University of Edinburgh, and Royal Infirmary of Edinburgh Trust Hospital, Edinburgh, United Kingdom. Methods: This prospective study comprised 792 consecutive patients having cataract extraction by one surgeon from 1989 to 1993. Outcome measures were incidence of pupillary capture associated with eye disease and treatment, surgical technique, and intraocular lens (IOL) placement and style; postoperative progress; and results of Nd:YAG treatment. Results: Pupillary capture developed in 30 of the 764 patients (3.9%) having implantation of a posterior chamber IOL a mean of 14 weeks postoperatively (range 2 to 44 weeks). The incidence was significantly higher in eyes with angle-closure glaucoma, combined glaucoma and cataract surgery, can-opener capsulotomy, manual extraction, sulcus IOL implantation, large-optic IOLs, and one-piece IOLs. Neodymium:YAG laser treatment was successful in 8 of 12 eyes. Conclusion: Pupillary capture may be anticipated and when recognized at an early stage, treated successfully with an Nd:YAG laser in most cases.