Optometrists demonstrate the ability to safely and effectively perform the Neodymium-doped yttrium aluminum garnet (ND:YAG) laser capsulotomy procedure, according to a study published in Optometry and Vision Science. A lack of complications and patient-reported outcomes indicating improved vision following the procedure show that optometrists are capable of administering a treatment once exclusively performed by ophthalmologists.
Although optometrists have been performing this procedure in some states since 1998, legislation enacted within the last few years has recently expanded optometry’s scope of practice, allowing optometrists to perform the procedure in other states.
“While there have been no adverse events from optometry-performed lasers reported in the literature, likewise there has been no published study assessing the efficacy and safety of laser procedures, such as YAG capsulotomy, performed by optometrists,” according to the study authors.
Researchers included patients (n=79; eyes, 92) from the Northeastern State University Oklahoma College of Optometry and 5 other clinical sites in the prospective investigation who underwent the ND:YAG capsulotomy procedure, performed by an optometrist. Investigators obtained visual acuity, intraocular pressure (IOP), and macular thickness measurements and noted any central lens defects at baseline and repeated measurements during 1- and 3-month follow-up visits. Study participants completed subjective surveys noting vision improvements following the procedure.
Visual acuity significantly improved from baseline during the 1-month follow-up (20/40 vs 20/30; P < .001) and this improvement was maintained at the 3-month visit. No significant adverse events were noted with respect to increased IOP, inflammation, visually-significant lens pitting, macular edema, or retinal detachment. A total of 99% of patients reported a subjective improvement in their vision after the procedure.
“With minimal risk, a quick learning curve, and required slit lamp skills already possessed by optometrists, laser procedures can be effectively used by optometrists to provide patients easier access to high quality eye care,” according to the researchers.
Study limitations include an inability to mask participants and failure to perform formal assessment of vision quality which include contrast sensitivity and glare testing.
Lighthizer N, Johnson S, Holthaus J, et al. Nd:YAG laser capsulotomy: efficacy and outcomes performed by optometrists. Optom Vis Sci. Published online August 18, 2023. doi:10.1097/OPX.0000000000002057