Background: posterior capsular opacification (PCO), also known as ‘secondary cataract' or ‘after cataract', develops a few months to a few years over the clear posterior capsule after an uncomplicated cataract surgery. Purpose: evaluation the impact of Neodymium-doped Yttrium Aluminum-Garnet (Nd: YAG) laser capsulotomy on central macular thickness (CMT) by optical coherence tomography (OCT). Patients and Methods: the present study examined 50 eyes (24 males, 26 females) with an average age of 63.58±7.7 which was pseudophakic and had PCO, preoperative evaluation included history taking, ophthalmological examination and OCT was done. All patients underwent YAG laser posterior capsulotomy and CMT assessed at 3 days, 1 week, 1 month and 3 months by OCT. Results: there was significant improvement of BCVA (LogMAR) post laser capsulotomy (P< 0.001), IOP statistically significant increased (P< 0.001) at the first postoperative 3 days, 1 week, 1 month with mean ±SD of 16.46±2.54 mmHg 17.50±2.67 mmHg ,15.50±2.39 mmHg respectively when compared to preoperative values 13.0±1.67 mmHg. At 3 months there was minimal change (P=0.02). As regard CMT values at 1 week post laser (mean ±SD of 270.92±24.88) was highly significant increased (P< 0.001) and values at 3 months (mean ±SD of 248.70±21.66) showed nonsignificant difference (P=0.285) when compared to pre laser values (mean ±SD of 245.58±23.30). Conclusion: typical treatment of the PCO is YAG laser capsulotomy, IOP elevation is the most prevalent complication so antiglaucoma drugs is recommended and IOP return to normal values in the follow up period.